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Objective: To compare Estonian and Finnish gynaecologists' and general practitioners' (GP) opinions on and prescribing practices in hormone treatment (HT) during and after menopause., Methods: Data was collected using similar postal questionnaires. In 2000 in Estonia, a random sample included 212 gynaecologists and 288 GPs (68% responded); and in 1989 in Finland, 100 male and 100 female gynaecologists, 100 general practitioner specialists and 100 non-specialists (73% responded). Gynaecologists and GPs were compared to each other within the countries, and the two countries were compared within the specialities., Results: Gynaecologists' opinions of benefits were positive and similar in Estonia and Finland, and more positive than those of GPs. Gynaecologists and GPs in both countries had similar opinions about harms. Gynaecologists were in favour of longer HT than GPs, and longer treatment was recommended in Finland than in Estonia. In both countries a large proportion of physicians (48% of gynaecologists in Estonia and 65% in Finland) stated that they would routinely prescribe HT to all women at menopause without contraindication, regardless of symptoms, and some (31% of gynaecologists in Estonia and 19% in Finland) favoured routine prescribing to all postmenopausal women., Conclusions: Estonian physicians' positive attitudes suggest increased use of HT. Comparisons of the two countries and specialities suggest that physicians' positive opinions may long predate increased use.

Background: This study describes reproductive health, use of contraception, age at menopause, the prevalence of climacteric complaints, and hormone replacement therapy among Estonian women born in 1937-47.Methods: A sample of 800 Estonian women born in 1937-47 was composed at random from the Estonian population registry in 1997. A postal questionnaire was sent to all participants.Results: Curettage before menopause (16.6%, 95%CI=13.5-20.0) and hysterectomy (11.7, 95%CI =9.0-14.8) were the most common gynecological operations. 66.7% (95%CI =62.5-70.6) of women had never used contraception, with the most popular method of contraception being intrauterine device (19.9%, 95%CI = 16.6-23.6). About three quarters of the respondents had had induced abortions, with 30.4% (95%CI =26.5-34.4) having had three or more abortions. After exclusion of women with surgical menopause (57 cases, 10.6%, 95% CI=8.1-13.5), women who were unable to assess the time of menopause (17 cases, 3.2%, 95%CI=1.8-5.0), and those who were still menstruating (73 cases, 13.6%, 95%CI = 10.8-16.8), the average age of menopause (based on 388 study subjects) was 50.3 (95%CI =49.9-50.6) years. The prevalence of climacteric complaints was as follows: hot flushes 51.0% (95%CI =46.7-55.3), night sweats 44.1% (95%CI =39.9-48.4%), depression/irritability 35.6% (95%CI =31.5-39.8), bleeding problems 10.1% (95%CI=7.6-12.9). Hormone replacement therapy was currently being used by 8 respondents (1.5%, 95%CI=0.6-2.9). Previous hormone replacement therapy use was reported by 4 (0.7%, 95% CI =0.2 2.9) of the women.Conclusions: The feminine life-course of women born in Estonia in 1937-47 is characterized by a high number of induced abortions and hysterectomies, and relatively little contraceptive use. Hormone replacement therapy use is very low. [ABSTRACT FROM AUTHOR]

Background: The interest of patients in participating in randomized clinical trials involving treatments has been widely studied, but there has been much less research on interest in preventive trials. The objective of this study was to find out how many women would be interested in a trial involving postmenopausal hormone therapy (PHT) and how the women's background characteristics and opinions correlated to their interest. Methods: The data come from recruitment questionnaires (n = 2000) sent to women in Estonia in 1998. A random sample of women aged 45 to 64 was drawn from the Population Registry. The trial is a twogroup randomized trial comparing estrogen-progestogen therapy with placebo or no drugs. A brief description of the study was attached to the questionnaires. Women were not told at this stage of the recruitment which group they would be assigned to, however, they were told of the chance to receive either hormone, placebo or no treatment. Results: After two reminders, 1312 women (66%) responded. Eleven percent of the women approached (17% of the respondents) were interested in joining the trial, and 8% wanted more information before deciding. When the 225 women who stated clearly that they were interested in joining and the 553 women who said they were not interested were compared, it was found that interested women were younger and, adjusting for age, that more had given birth; in other respects, the sociodemographic characteristics and health habits of the interested women were similar to those of the non-interested women. The interested women had made more use of more health services, calcium preparations and PHT, they were more often overweight, and more had chronic diseases and reported symptoms. Interested women's opinions on the menopause were more negative, and they favoured PHT more than the non-interested women. Conclusion: Unlike the situation described in previous reports on preventive trials, in this case Estonian women interested in participating in a PHT trial were not healthier than other women. This suggests that trials involving PHT are more similar to treatment trials than to preventive trials. In a randomized controlled trial, more information should be obtained from those women who decline to participate. [ABSTRACT FROM AUTHOR]