Journal article
Factors associated with hormone replacement therapy use: a systematic review and meta-analysis
- Abstract:
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Objective: To identify factors associated with HRT uptake among women.
Design: A systematic review and meta-analysis to identify factors associated with HRT uptake.
Setting: Retrospective and prospective cohort studies, case-control studies and crosssectional from any country and in any language.
Population: The study population was women aged 40-60 years old.
Methods :We searched Medline, Embase, CINAHL and Cochrane databases to identify studies reporting associations between demographic, behavioural, or healthrelated factors and HRT uptake. Studies were selected if they reported numbers or odds ratios of the factors and HRT uptake. Studies were combined for metaanalysis, reporting odds ratios and 95% confidence intervals. Quality assessment was performed to quantify the risk of bias.
Main outcome measures: HRT uptake, defined as “ever” versus “never” users.
Results: 5,124 papers were identified for title and abstract screening; 136 full texts were screened; 53 were included in meta-analyses. HRT uptake was 53% lower in Black (OR 0.47, 0.30-0.73) compared to White women. Diabetes, obesity, and history of stroke or venous thromboembolism were associated with lower HRT uptake; (OR 0.71, 0.59-0.85; 0.67, 0.56-0.81; 0.75, 0.63-0.89; 0.78, 0.74-0.0.83 respectively). Osteoporosis and depression were associated with higher HRT uptake; (OR 1.64, 1.10-2.45 and 1.69, 1.17-2.43 respectively).
Conclusions: There are differences in HRT uptake by ethnicity and health characteristics. However, findings are not generalisable globally. Our results could aid healthcare professionals and policymakers to address the gaps in HRT uptake and promote healthcare equity.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 412.1KB, Terms of use)
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- Publisher copy:
- 10.1111/1471-0528.70160
Authors
- Funder identifier:
- https://ror.org/0187kwz08
- Grant:
- NIHR204901
- Publisher:
- Wiley
- Journal:
- BJOG: An International Journal of Obstetrics & Gynaecology More from this journal
- Publication date:
- 2026-01-22
- Acceptance date:
- 2026-01-07
- DOI:
- EISSN:
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1471-0528
- ISSN:
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1470-0328
- Language:
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English
- Keywords:
- Pubs id:
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2356946
- Local pid:
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pubs:2356946
- Source identifiers:
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W7125521998
- Deposit date:
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2026-01-07
- ARK identifier:
Terms of use
- Copyright holder:
- Mtika et al.
- Copyright date:
- 2026
- Rights statement:
- © 2026 The Author(s). BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium,provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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