Understanding risk: women's perceived risk of menopause-related disease and the value they place on preventive hormone replacement therapy.

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Abstract
Objectives. The aims of this study were to determine women’s perceived risk of menopause-related disease and to understand how this shapes their decisions about taking hormone replacement therapy (HRT) for disease prevention. Methods. A qualitative study based on analysis of audio-taped semi-structured interviews. The study was carried out in a community setting in Surrey. The participants were 32 women aged 51 to 57 years, registered with GPs in the West Surrey Health Authority. Results. Women’s ideas about the risk of menopause-related disease exist on two levels; a collective and an individual level. At a collective level, women acknowledge an increased risk of osteoporosis, and to a lesser degree, a risk of heart disease, associated with the menopause. At an individual level, however, based mainly on their family history and lifestyle, women do not generally consider themselves to be at personal risk of disease. Decisions to take HRT for the prevention of menopause-related disease are largely based on individual assessments of risk and, therefore, most women see a limited value in taking HRT primarily for disease prevention. Conclusions. Whilst women tend to associate the menopause with an increased risk of disease, they do not generally consider themselves to be at personal risk, and in turn, choose not to take HRT primarily for prevention.

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