Hormone therapy use higher among midlife active-duty servicewomen, but gaps remain
Key takeaways:
- There is a “significant gap” among midlife servicewomen who are candidates for hormone therapy and those receiving it.
- More education is needed for servicewomen on the benefits of HT for menopause symptoms.
Use of menopausal hormone therapy among midlife active-duty servicewomen in the U.S. is twice as high as the general population but lower than women veterans, suggesting those who may derive the most benefit from HT are not receiving it.
“The discrepancy in hormone therapy use between the number of servicewomen who are likely appropriate candidates for it and the number actually receiving it may stem from a gap in both participants’ and providers’ attitudes and knowledge regarding its benefits for vasomotor symptoms,” Miranda L. Janvrin, MPH, research associate at the Uniformed Services University of Health Sciences and The Henry M. Jackson Foundation for the Advancement of Military Medicine, told Healio. “Despite this higher prevalence compared to the general population, a significant gap remains between the number of servicewomen currently receiving hormone therapy and those who could benefit from it. It is important that patients and providers understand the risk-benefit ratio of hormone therapy for treating vasomotor symptoms.”
Janvrin and colleagues conducted a retrospective cross-sectional study with 13,629 active-duty servicewomen aged 45 to 64 years in the U.S. Army, Air Force, Navy and Marine Corps between 2018 and 2022, using data from the Military Health System Data Repository. Researchers evaluated the frequency of menopausal HT use among active-duty servicewomen.
Overall, 9.5% of active-duty servicewomen reported systemic menopausal HT use, a rate higher than the reported 4.7% among the general midlife population but lower than the 10.3% reported among midlife women veterans, according to researchers. Oral therapy was the most commonly prescribed form of menopausal HT (65%).
Compared with women aged 50 to 54 years, active-duty servicewomen aged 45 to 49 years (OR = 0.25; 95% CI, 0.23-0.3) and 60 to 64 years (OR = 0.48; 95% CI, 0.26-0.87) were less likely to receive HT.
“[It is surprising] how low the prevalence of hormone therapy use is among servicewomen aged 45 to 64 years despite its known benefits for women in this age group,” Janvrin told Healio. “Additionally, servicewomen have universal health care coverage with no payment for prescription drugs or copayment for doctor’s visits. So, despite the removal of financial barriers and universal coverage, servicewomen still do not use the hormone therapy despite the potential benefit.”
In analyses stratified by race and officer rank, women of Asian/Pacific Islander race (OR = 0.67; 95% CI, 0.53-0.85) had the lowest use of HT compared with white women, whereas women ranked as junior enlisted (OR = 0.12; 95% CI, 0.03-0.48), senior enlisted (OR = 0.73; 95% CI, 0.63-0.85) or junior officer (OR = 0.82; 95% CI, 0.7-0.96) had significantly lower odds of systemic HT use compared with those with the rank of senior officers.
Researchers observed no significant associations between menopausal HT use and service branch.
“There is currently a lack of data explicitly examining provider practice patterns and patient attitudes and perceptions regarding menopause care of service women,” Janvrin told Healio. “Additional research is needed to address this gap as well as to determine if there are any differences in menopause care practices between direct and private care practitioners.”
For more information:
Miranda L. Janvrin, MPH, can be reached at @mirandajanvrin on X.