The emergence of new evidence on the benefits and risks of hormone replacement therapy (HRT) throughout the past two decades has led to ongoing revisions to clinical practice guidelines on HRT use. Current Canadian menopause and osteoporosis guidelines recommend consideration of the potential risks and benefits to patients, whether prescribing HRT for menopausal symptoms or for fracture prevention. Canadian menopause guidelines also recommend the primary indication for HRT be to manage moderate to severe menopause symptoms, and that it be prescribed at the lowest effective dose and for the appropriate duration to achieve the treatment goals.
The use of HRT has fluctuated over the years with the publication of changing evidence. Several studies have shown significant declines in HRT use since the publication of the Women's Health Initiative (WHI) study in 2002. The results of this analysis are consistent with these studies. The number of HRT users among female seniors in Alberta, Saskatchewan, Manitoba, New Brunswick and Nova Scotia declined by 17.0% per year between 2001-2002 and 2006-2007, and by 30.0% per year in the two-year period following publication of the WHI 2002 study results.
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