Nothing stirs up controversy among women like hormone replacement therapy (HRT). No matter where women live, HRT is a source of confusion, fear, and mistrust. Are the risks any different for women living in nations in transition compared to more developed areas? A recent study on women living on Borneo Island, located in the East Indies of Southeast Asia, examined the attitudes and beliefs about HRT.

As distant as this information first appears, understanding the evolution of menopause treatment provides doctors, researchers, and patients better methods to address women’s health care issues. Even more imporant is knowing that the most accessible sources of information are not necessarily the best ones.

This study focused on how informed Borneo Island women were about HRT, and how many women were taking HRT for menopausal symptoms. In particular, the participants selected lived in Sarawak State region of the island. A group of 356 women, aged between 40 and 65 years took part in personal interviews conducted to assess attitudes and awareness about HRT.

The average age of the women was 50 and the average age of menopause was 51, which corresponds to the generally accepted menopausal benchmarks. Just under one quarter (23%) of the women were premenopausal, over one-third (39.6%) were perimenopausal, and 37.4% were postmenopausal; 77% of the participants were in some stage of going through menopause.

One of the outcomes noted that only 36% of the women in the study knew about HRT. Younger women who had higher levels of education and who tended to be employed were better informed than their older and less educated peers were. Researchers wanted to know how these women learned about HRT and the results are typical when compared to Western women. Friends and relatives: 92.2%, newspapers and magazines: 89.1%, and television and radio: 64.1% were the most reported sources for menopause information.

Overall, only about 8% of the women in this survey said that they were using some form of HRT therapy for treating various menopausal symptoms including night sweats, mood swings, irritability, hot flashes, and osteoporosis prevention. Every woman taking HRT had done so for less than three years. What accounts for such low numbers of HRT use compared to higher levels of awareness, especially for the younger women?

The most common reason given by the participants was a lack of information coming from the women’s healthcare providers. In fact, over half of the women (56.6%) stated that their doctors had not recommended or even discussed HRT as a menopause treatment option. This becomes more important when only 8% of the women had any concerns about the well-published side effects, which often leave Western women skeptical about HRT. Women in this Borneo Island study were not so much afraid of taking HRT, as they were uninformed.

This leaves doctors with the urgent task of becoming better informed about menopause and HRT, and delivering this information to patients. Women everywhere require greater access to quality healthcare and the facts about HRT in order to make informed menopause treatment decisions. This research demonstrates the gains in women’s healthcare and encourages physicians to open the lines of communication with patients. Women everywhere, particularly those living in nations in transition, deserve better when it comes to HRT information than merely relying on the latest media hype.

“Hormone replacement therapy among women of Borneo Island” Syed Adbul Rahman, Syed Alwi, Lee Ping Yein, M.N. Md Haizal, (Malaysia) – University Malaysia Sarawak, as presented at the 13th World Congress on Menopause, Rome, 2011.

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