Hormone Therapy and Menopausal Symptoms Among Women Participating in a Behavioral Lifestyle Intervention: The Women’s Healthy Lifestyle Project
The decision to take hormone replacement therapy (HRT) is a choice many women encounter when entering menopause. In light of controversy of the benefits and risks of HRT use, an important question to ask is on what basis are women taking HRT, and are they taking hormone therapy because they are at higher risk. The purpose of this study was to examine HRT use in women who are participating in a behavioral lifestyle intervention through the menopause. The Women’s Healthy Lifestyle Project (WHLP) was a 5-year randomized clinical trial designed to examine whether a behavioral lifestyle intervention could decrease the expected rise in cardiovascular risk through the menopause. A sample of 535 healthy premenopausal women, aged 44-50 years (M=47 + 1.9) participated in the study. The intervention was highly successful in buffering risk elevation through the 54-month visit. The control group gained 5.2 lb over the 54 month study and the intervention group remained 0.18 lb below baseline (p=.00). The intervention group’s LDLc increased by 3.5 mg/dl, and the control group’s LDLc increased by 8.9 mg/dl (p=.01). At the 54-month visit, there was no difference between the intervention and control groups in menopausal status, with 34.7% of the women postmenopausal. There was no difference between intervention and control groups with regard to HRT use, with 31.2% of the total sample reporting use of HRT. Further, there was no difference in menopausal symptoms between treatment groups. The women started HRT an average of 6 months after they missed a period. Analysis was done to examine predictors of HRT use in this group of women. Baseline cardiovascular risk factors did not predict HRT use at the 54-month visit. Moreover, the number of menopausal symptoms did not predict HRT use at 54 months. There was little difference between the women who were taking HRT and the women who were not taking HRT. There was a high use of HRT in this group of healthy, well-educated women. But an intensive lifestyle intervention did not change the use of HRT.