Women's and Health Care Professionals' Experiences of Discontinuing Hormone Replacement Therapy ( HRT ): A Systematic Review

作者：Sarah Bunnewell, Sabrina Keating, Jo Parsons, Martha Hickey, Sarah Hillman · 发表于：BJOG An International Journal of Obstetrics & Gynaecology · 年份：2025 · DOI：10.1111/1471-0528.70023 · 被引用次数：5 · 研究领域：Menopause: Health Impacts and Treatments、Sexual function and dysfunction studies、Hormonal and reproductive studies

BACKGROUND: Hormone Replacement Therapy (HRT) is used to manage menopausal symptoms, particularly vasomotor symptoms (VMS). HRT prescribing rates are rising, but most women will eventually discontinue. OBJECTIVES: To explore the experiences of women stopping HRT, why women restart HRT, and the HCPs advising them. SEARCH STRATEGY: Embase, MEDLINE, CINAHL, Web of Science and PsycINFO were searched from 2000 to February 2024. SELECTION CRITERIA: Quantitative, qualitative and mixed methods studies assessing experiences of HRT discontinuation. DATA COLLECTION AND ANALYSIS: Quality was appraised using the Mixed Methods Appraisal Toolkit (MMAT). Data were narratively synthesised with weighted averages reported where possible. MAIN RESULTS: Electronic database searches identified 9444 reports, with 74 reports from 69 studies, including 32 213 women and 2943 HCPs. Average age of the cohort analysed was 64.7 years. Discontinuation rate was 51.3%, with average HRT duration of 5.4 years. The majority of women abruptly stopped HRT (62.4%). Common reasons for discontinuation were HCP recommendation (31.2% of participants), fear about risks (26.0%) and preference for a natural approach (25.6%). Common symptoms upon discontinuation were unspecified menopausal symptoms (84.4%), sleep disturbances (51.9%) and VMS (45.4%). Four RCTs compared tapered and abrupt discontinuation; two found abrupt discontinuers had greater symptoms initially, but symptoms were comparable to those experienced by tap...