Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making

Persistent Link:
http://hdl.handle.net/10150/626039
Title:
Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making
Author:
Thompson, Jennifer Jo; Ritenbaugh, Cheryl; Nichter, Mark
Affiliation:
Univ Arizona, Dept Family & Community Med; Univ Arizona, Sch Anthropol
Issue Date:
2017-10-02
Publisher:
BIOMED CENTRAL LTD
Citation:
Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making 2017, 17 (1) BMC Women's Health
Journal:
BMC Women's Health
Rights:
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.
Collection Information:
This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
Abstract:
Background: In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)-despite concerns within the medical community and the availability of new FDA approved "bioidentical" products. This study aims to characterize the motivations for using CBHT in a U.S. sample of ordinary midlife women. Methods: We analyze data collected from 21 current and former users of CBHT who participated in a larger qualitative study of menopausal decision-making among U.S. women. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed thematically using an iterative inductive and deductive process. Results: Although women's individual motivations varied, two overarching themes emerged: "push motivations" that drove women away from conventional HT and from alternative therapies, and "pull motivations" that attracted women to CBHT. Push motivations focused on (1) fear and uncertainty about the safety of conventional HT, (2) an aversion to conjugated estrogens in particular, and (3) and overarching distrust of a medical system perceived as dismissive of their concerns and overly reliant on pharmaceuticals. Participants also voiced dissatisfaction with the effectiveness of herbal and soy supplements. Participants were attracted to CBHT because they perceive it to be (1) effective in managing menopausal symptoms, (2) safer than conventional HT, (3) tailored to their individual bodies and needs, and (4) accompanied by enhanced clinical care and attention. Conclusions: This study finds that women draw upon a range of "push" and "pull" motivations in their decision to use CBHT. Importantly, we find that women are not only seeking alternatives to conventional pharmaceuticals, but alternatives to conventional care where their menopausal experience is solicited, their treatment goals are heard, and they are engaged as agents in managing their own menopause. The significance of this finding goes beyond understanding why women choose CBHT. Women making menopause treatment decisions of all kinds would benefit from greater shared decision-making in the clinical context in which they are explicitly invited to share their experiences, priorities, and preferences. This would also provide an opportunity for clinicians to discuss the pros and cons of conventional HT, CBHT, and other approaches to managing menopause.
ISSN:
1472-6874
PubMed ID:
28969624
DOI:
10.1186/s12905-017-0449-0
Keywords:
Menopause; Hormone therapy; Bioidentical hormones; Compounded hormones; Shared decision-making; Qualitative research
Version:
Final published version
Sponsors:
National Science Foundation (DDRIG) [0718313]; National Institutes of Health [T32AT001287-06]; University of Arizona's Social and Behavioral Sciences Research Institute; School of Anthropology; Department of Family and Community Medicine; Program in Integrative Medicine
Additional Links:
http://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-017-0449-0

Full metadata record

DC FieldValue Language
dc.contributor.authorThompson, Jennifer Joen
dc.contributor.authorRitenbaugh, Cherylen
dc.contributor.authorNichter, Marken
dc.date.accessioned2017-11-13T15:57:09Z-
dc.date.available2017-11-13T15:57:09Z-
dc.date.issued2017-10-02-
dc.identifier.citationWhy women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making 2017, 17 (1) BMC Women's Healthen
dc.identifier.issn1472-6874-
dc.identifier.pmid28969624-
dc.identifier.doi10.1186/s12905-017-0449-0-
dc.identifier.urihttp://hdl.handle.net/10150/626039-
dc.description.abstractBackground: In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)-despite concerns within the medical community and the availability of new FDA approved "bioidentical" products. This study aims to characterize the motivations for using CBHT in a U.S. sample of ordinary midlife women. Methods: We analyze data collected from 21 current and former users of CBHT who participated in a larger qualitative study of menopausal decision-making among U.S. women. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed thematically using an iterative inductive and deductive process. Results: Although women's individual motivations varied, two overarching themes emerged: "push motivations" that drove women away from conventional HT and from alternative therapies, and "pull motivations" that attracted women to CBHT. Push motivations focused on (1) fear and uncertainty about the safety of conventional HT, (2) an aversion to conjugated estrogens in particular, and (3) and overarching distrust of a medical system perceived as dismissive of their concerns and overly reliant on pharmaceuticals. Participants also voiced dissatisfaction with the effectiveness of herbal and soy supplements. Participants were attracted to CBHT because they perceive it to be (1) effective in managing menopausal symptoms, (2) safer than conventional HT, (3) tailored to their individual bodies and needs, and (4) accompanied by enhanced clinical care and attention. Conclusions: This study finds that women draw upon a range of "push" and "pull" motivations in their decision to use CBHT. Importantly, we find that women are not only seeking alternatives to conventional pharmaceuticals, but alternatives to conventional care where their menopausal experience is solicited, their treatment goals are heard, and they are engaged as agents in managing their own menopause. The significance of this finding goes beyond understanding why women choose CBHT. Women making menopause treatment decisions of all kinds would benefit from greater shared decision-making in the clinical context in which they are explicitly invited to share their experiences, priorities, and preferences. This would also provide an opportunity for clinicians to discuss the pros and cons of conventional HT, CBHT, and other approaches to managing menopause.en
dc.description.sponsorshipNational Science Foundation (DDRIG) [0718313]; National Institutes of Health [T32AT001287-06]; University of Arizona's Social and Behavioral Sciences Research Institute; School of Anthropology; Department of Family and Community Medicine; Program in Integrative Medicineen
dc.language.isoenen
dc.publisherBIOMED CENTRAL LTDen
dc.relation.urlhttp://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-017-0449-0en
dc.rights© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.en
dc.subjectMenopauseen
dc.subjectHormone therapyen
dc.subjectBioidentical hormonesen
dc.subjectCompounded hormonesen
dc.subjectShared decision-makingen
dc.subjectQualitative researchen
dc.titleWhy women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-makingen
dc.typeArticleen
dc.contributor.departmentUniv Arizona, Dept Family & Community Meden
dc.contributor.departmentUniv Arizona, Sch Anthropolen
dc.identifier.journalBMC Women's Healthen
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen

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