Swedish gynecologists' and general practitioners' views on the climacteric period, Knowledge, attitudes and management strategies

Aims. To investigate attitudes, knowledge and management strategies concerning hormone replacement therapy (HRT) among gynecologists and general practitioners (GPs) in Sweden. Material and methods. In 1996 a questionnaire was sent to all Swedish gynecologists (n1323) and every third general practitioner (GP) (n1397) regarding indications, contraindications, treatment regimens and their own (or their wives') use of estrogens. Results. Answers were received from 53% of the GPs and from 80% of the gynecologists. Fifteen per cent of the GPs often considered it difficult to evaluate the advantages and disadvantages of hormone replacement therapy compared to 2% of the gynecologists (p0.001). Almost 100% of the physicians considered hot flushes, night sweats and osteoporosis to be indications for HRT. Significantly more GPs compared to gynecologists (50% vs 24%) stated that estrogen increased the risk of developing a deep vein thrombosis. Significantly more GPs performed measurements of blood pressure, weight, lipoproteins and palpated the breasts before starting treatment and at the follow-up visits. Significantly more gynecologists performed pelvic examination, vaginal sonography, endometrial biopsy and mammography. Among the female doctors who were either postmenopausal or had climacteric symptoms 72% of the GPs and 88% of the gynecologists were current users of HRT (p0.01). Corresponding figures for the wives were 68% vs 86% (p0.001).