Objective: We aimed to explore the longitudinal impact of the widely-publicised Women’s Health Initiative (WHI) 2002 study on women’s information-seeking and describe determinants of decision-making about managing menopausal symptoms.
Methods: We extracted consumer questions about menopause-related medicines received by two Australian medicines call centres (1996-2010) before, during, and after WHI 2002. Call information was analysed by age and gender of caller and patient, their relationship, postcode, enquiry type, and motivation to call. We compared calls regarding menopause-related hormone therapy (HT) and herbal medicines (HM) with the rest of calls, and thematically analysed question narratives.
Results: There were 1,829 menopause-related calls received of this time frame, with a call surge, primarily from women in their mid-fifties, in the two months after the initial WHI 2002 publication. Two in three calls were motivated by negative media reports as women sought support for decision-making, primarily reassurance to cease HT. While HT safety concerns persisted for eight-year post-WHI publication, the nature of information-seeking changed over time. Callers subsequently sought reassurance to use menopause treatments together with their other medicines; and pursued HT substitutes, including HM, in response to HT product discontinuation. Women sought information or reassurance to support a decision, based on dynamic changes in internal (symptom or risk intolerance, attitude towards menopause and treatment preferences) and external factors (perceived source trust and changes in treatment availability).
Conclusions: In assessing HT benefit versus risk, women tend to overestimate risk, with HT safety concerns persisting over time. Decision-making in managing menopause symptoms is complex and dynamic. Reassurance to reach or justify decisions from a perceived trusted source can support informed decision-making.