BACKGROUND: The decision to take hormone replacement therapy (HRT) is a choice many women encounter when entering menopause. The purpose of this study was to examine the choice to take HRT while participating in a lifestyle intervention to reduce cardiovascular risk through the menopause. METHODS: The Women's Healthy Lifestyle Project is a randomized clinical trial designed to examine whether a behavioral lifestyle intervention can decrease the expected rise in cardiovascular risk through the menopause. Participants (N = 535) completed questionnaires and were interviewed regarding menopausal symptoms, menopausal status, hot flashes, and HRT use at baseline and 54 months. RESULTS: The intervention was successful in preventing risk elevation through the 54-month visit. At the final visit, there was no difference between the intervention and control groups in the percentage who had become postmenopausal (32.9% versus 35.0%, respectively), there was no difference between control and intervention with HRT use, with 31.2% reporting use of HRT, and there was no difference between groups with menopausal symptoms. The women started HRT an average of 6 months after they missed a period. Baseline risk factors did not predict HRT use at the 54-month visit. CONCLUSIONS: A sizable number of women reported HRT use. The decision to use HRT was not influenced by the lifestyle intervention or their baseline cardiovascular risk, and these women started HRT very early in the peri- to postmenopause. Further, weight loss in the perimenopause did not affect menopausal symptoms.
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