Biomedical subjects

J G Posner

Publications and source records attributed to J G Posner.

3 recordsLinked to original sources

PubMed1994

Longitudinal patterns and correlates of hormone replacement therapy use in middle-aged women.

Patterns of hormone replacement therapy (HRT) use over time and predictors of initiating or discontinuing use were examined in a longitudinal study. A cohort of 2,425 women aged 45-55 years identified from a population-based random survey in Massachusetts in 1981-1982 was followed by six telephone interviews, 9 months apart. Cohort participants were either premenopausal (66.8%) or in early perimenopause (33.2%). During the study, prevalence of use was low overall (12.3%) and was considerably higher for surgical menopause (45%) than for peri- (9.3%), natural (4.5%), or premenopause (1.5%). Predictors of HRT uptake and discontinuation (from time t - 1 to time t) were examined by repeated-measures logistic regression, stratified by surgical status. For surgical menopause, the only significant predictor of HRT uptake was recent surgery (odds ratio = 4.4; 95% confidence interval 2.73-7.22), while for nonsurgical subjects, menopausal status (primarily perimenopause), prior use of HRT, health care utilization, hot flashes, alcohol consumption, regular exercise, and leaner body mass were all significant predictors of uptake. Discontinuing HRT was inversely associated with surgical and perimenopause and positively related to prior short-term use and health care utilization. Nonsurgical HRT users had a somewhat more favorable cardiovascular risk profile than did nonusers.

Climacteric↗

PubMed1992

The normal menopause transition.

This paper presents analyses from perhaps the largest and most comprehensive prospective cohort study of mid-aged women--the Massachusetts Women's Health Study (MWHS)--with numbers sufficient to provide, for the first time, stable estimates of parameters in the normal menopause transition. The three questions addressed in this analysis are (i) what are the natural menopause transitions and when do they occur, (ii) what factors affect these transitions and (iii) what signs and/or symptoms accompany these transitions? The data were obtained primarily from 5 years of follow-up of 2570 women in Massachusetts who were aged 45-55 years as of January 1, 1982. An initial baseline cross-sectional survey (T0) yielded a total of 8050 completed responses with an overall response rate of 77%. From this cross-sectional sample a cohort of approximately 2570 women was identified, consisting of women who had menstruated in the preceding 3 months and who had not undergone removal of the uterus and/or ovaries. Prospective study of the cohort consisted of six telephone contacts (T1-T6) at 9-month intervals with excellent retention of the respondents. A subset of the full cohort was defined that consisted of women who were premenopausal (rather than perimenopausal) at baseline (T0) (n = 1178). Confirming prior reports, the age at natural menopause occurred at 51.3 years with a highly significant median difference (1.8 years) between current smokers and non-smokers. The new analyses reported here on median age at inception of perimenopause (47.5 years) and factors affecting it are consistent with findings for age at last menstrual period, particularly the overwhelming effect of smoking. Smokers tend to have not only an earlier but also a shorter perimenopause. The length of the perimenopausal transition (estimated at nearly 4 years) has not been previously reported. Moreover, the highest rate of physician consultations is observed among those with longer perimenopause transitions. The relationship between menopause transitions and symptom reporting appears to be transitory, with reported rates showing an increase in the perimenopause and a compensatory decrease in the postmenopause. The implications of combined hormone replacement therapy for future research on menopause in industrial societies is discussed in relation to these findings.

Age Factors↗

PubMed1991

Use of estrogens among middle-aged Massachusetts women.

This study describes estrogen use among 45- to 55-year-old white women in Massachusetts from 1981 to 1987. In a 1981 cross-sectional survey, 7705 white women (77 percent response rate) returned a questionnaire or were interviewed by phone. Premenopausal women were invited into a 4.5-year follow-up study including telephone interviews every nine months, and 2236 (approximately 91 percent of the eligible women) had a complete follow-up. In the cross-sectional survey, 7.9 percent had used oral estrogens in the last two weeks, but most (77 percent) had had a hysterectomy; use varied notably from one area to another. Vaginal estrogens were used by 2.9 percent. Users and nonusers of oral estrogens were quite similar in regard to sociodemographic background. Data from the follow-up surveys showed that estrogen use increased throughout the study period and by the final follow-up women with higher education status reported more estrogen use than those with lower education status. Most women used estrogens only for a short time.

Drug Utilization↗