Hormone Replacement Therapy Use After Premature Surgical Menopause and Impact on Subsequent Health Services
Bibliographic record
Abstract
Introduction/Background: It is well-recognized that premature surgical menopause without subsequent hormone replacement therapy (HRT) is associated with increased morbidity and mortality. Our objective was to describe HRT use in a cohort of women from British Columbia (BC), Canada with premature surgical menopause.Methodology: A population-based retrospective cohort study of women who underwent surgical menopause between ages 19-50, identified from Medical Service Plan Payment Information from BC, and linked to prescription histories from the provincial PharmaNet database from 2004-2014. Women with personal history of cancer were excluded. Results: A total of 11,864 women were included. Median age of surgical menopause was 43 years. Median follow-up duration was 5.5 years (range: 0-10 years). The majority of women did not have a BRCA mutation (99.1%). They underwent bilateral salpingo-oophorectomy (90%) or bilateral oophorectomy (10.4%), and 50.5% had concurrent hysterectomy. There were 196 (1.7%) diagnosed with malignancy. The remainder had benign diagnoses, the most common of which were adnexal masses (17%), endometriosis (17.9%), and abnormal bleeding (14.3%). During the 10-year study period, only 55.4% had ever used HRT. Use of HRT for <6 months, 6-12 months, 1-5 years, and >5 years after surgery were 38.2%, 8.9%, 32.7%, and 20.2%, respectively. Those who did not use HRT had more physician visits for cardiovascular disease (19% vs. 9%) and osteoporosis (13% vs. 9%) compared to ever-users, respectively (p = 0.002). Conclusion: In this large population-based study investigating HRT rates following premature surgical menopause, only half of these women ever used HRT, and a greater proportion of those who did not use HRT had physician visits for cardiovascular diseases and osteoporosis. These results underscore a need for education and ongoing follow-up in this patient population.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.019 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.019 | 0.022 |
| Open science | 0.008 | 0.009 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.015 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".