General practitioners and current data on HRT: from information to practice

Abstract : Context: The medicalisation of the menopause was a major success story for over thirty years, up until July 2002, when randomised trials documented an increased risk of cardiovascular disease and breast cancer with HRT. In a few years the question "What are the contra- indications of HRT?" has become "What are the indications for HRT?". Question: Do certain personal characteristics of doctors facilitate the implementation of recommendations regarding HRT? Method: In-depth interviews with 15 general practitioners. Thematic analysis of the content of these interviews. Results: Every doctor is familiar with at least the broad outlines of the recommendations. Their social perceptions of the menopause and HRT are bound up with both biological and cultural phenomena : the social practices of HRT (medical, cosmetic and symbolic) come up in all the interviews. According to doctors a vast amount of information on the subject is available to women, mainly through the media, though this information is subjected to various interpretations that need to be set in the current context. Three variables (the effect of age, professional experience and period) situate the menopause and its hormonal treatment in a social framework, interacting on the knowledge and practice of physicians. A typology based on these variables may be put forward. The "convinced" doctors are those who hold regular gynaecological consultations. Recently set up in practice, they are in favour of HRT for its benefits on both the health capital and the symbolic capital. The recent data have somewhat unsettled them but not really challenged their practice. The "cautious" are the older, more experienced male doctors, for whom the protection of the health capital takes precedence over the symbolic capital. They no longer prescribe HRT, unsure which argument to put forward in its favour. The "malleable" are mainly the older female doctors, who consider that there are few references to offer women, question their own practice and adapt to the recommendations without too much trouble. Conclusion: The theme of the menopause and its hormone replacement therapy illustrates the difficulty in putting evidence-based medicine into practice. Prescribers' perceptions of the risks and benefits of HRT are a function of age, period
Type de document :
Communication dans un congrès
Rational Pharmacotherapy in General Practice, May 2005, Göttingen, Germany
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Contributeur : Violaine Garguilo <>
Soumis le : mercredi 21 mars 2012 - 08:50:28
Dernière modification le : jeudi 7 décembre 2017 - 11:46:17


  • HAL Id : hal-00681232, version 1



Nelly Duval, Gwénola Levasseur, Florence Douguet, Jean-Pierre Le Berre. General practitioners and current data on HRT: from information to practice. Rational Pharmacotherapy in General Practice, May 2005, Göttingen, Germany. 〈hal-00681232〉



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