Authors:

Nora Lee S. Reinhardt

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About Paper:

To characterize menopausal hormone therapy (MHT) prescribing patterns over 18 years in a large academic medical center and evaluate demographic and clinical factors associated with MHT use. We conducted a retrospective observational study using electronic health record data from 1/1/2007—2/31/2024. The cohort included biologically female patients 45 years or older with at least one outpatient encounter (N = 305,053). The primary outcome was the proportion of women with any documented MHT prescription. Prescriptions were categorized as local, systemic, or a combination (local + systemic). Associations between MHT use and race, birth year, comorbidity burden (Charlson Comorbidity Index), and urinary tract infection (UTI) history were evaluated using chi-square tests and multivariable logistic regression. Overall, 6.99% (21,327/305,053) of women had at least one documented MHT prescription. Among MHT prescriptions, 54.61% received local therapy, 37.66% systemic, and 7.37% combination, and 0.37% had unknown type. In adjusted analyses, African American (adjusted odds ratio [AOR] 0.467; 95% Cl 0.443—-0.492), Hispanic (AOR 0.563; 95% Cl 0.537—0.591), and Asian women (AOR 0.701; 95% Cl 0.635-0.772) had lower odds of MHT use compared with White women. Each additional comorbidity was associated with lower odds of MHT use (AOR 0.901; 95% CI 0.892-0.910). UTI history was strongly associated with MHT use (AOR 12.315; 95% Cl 11.73-12.93). MHT prescribing remained persistently low over 18 years, with marked racial disparities and reduced use among women with greater comorbidity burden, highlighting a sustained gap between evidence-based recommendations and real-world menopause care. oR ok oh ok ot oh oh ok ol ok ok ok ot ol ok ot off ofl ot ol okt ok ot oll of ofl ol ok ot ot ok ol ot ot ok ok ol ot ok ot ot at DDDFDDPDIDIIFDFIDIFIDIDDIIDIDDFIFGHDDIDIHDDIDHDIIIDHOD

Source:

Loyola University Chicago

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Co-authors:

Nora Lee S. Reinhardt