Management of Ambivalence Towards Hormone Replacement Therapy

Abstract

Indications for hormonal replacement therapy (HRT) after the menopause are twofold: 1) relief of postmenopausal symptoms secondary to estrogen deficiency and 2) risk reduction of diseases associated with estrogen deficiency [1]. Compliance is easier in symptomatic patients, when the efficacy in relieving disturbances is a major factor in satisfaction of use. Major compliance problems arise with the second indication, when, in absence of symptoms, the decision will rely not on the real benefits to be derived or the risks but on the perception of those benefits and risks [1]. Perception is a key mental step, as it involves subjective decision making and the many conflicting emotional and cognitive factors that may distort the decision-making process itself.