Shah Nighat, Tariq Hira, Khan Farah, Shah Nusrat
Dr. Nighat Shah, Associate Professor, Sindh Reproductive and Genetic Health Center, Jinnah Sindh Medical University, Karachi, Pakistan.
Dr. Hira Tariq, Lecturer, APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan.
Pak J Med Sci. 2023 Jan-Feb;39(1):128-132. doi: 10.12669/pjms.39.1.6176.
To assess the prescribing practice of obstetricians and gynecologists (OBGYN) regarding Menopausal Hormone therapy (MHT) for menopausal females and assess the knowledge regarding indications for prescribing MHT and identify the barriers to HRT.
This was a cross-sectional study conducted from May 2021 to December 2021. The participants were OBGYN experts (MCPS, FCPS, MRCOG) and senior experts. The tool was formulated after looking at contemporary literature and then validated by experts for face, content and construct validity. It was piloted and hence fourth given to study participants after approval by IRB of JSMU. Data was analyzed by SPSS version 22. Mean and Standard Deviation of categories in Likert scale were calculated.
Majority of the participant gynecologists prescribed HRT for Hot flushes and vaginal dryness having the highest mean scores nearing 4 on a Likert scale of (1-5). The prescription for other menopausal symptoms was observed to be less. The highest score for category of women in whom hormone therapy is specifically justified was "Premature ovarian failure" (4.37) followed by "Hysterectomy with bilateral oophorectomy before the age of 50" (4.23).
Pakistani gynecologists are more cautious in their management strategies concerning MHT. Most of the gynecologists showed good and up to date information while prescribing MHT however knowledge for preventing fractures, alleviating anxiety/depression and weight gain was less among the gynecologist of Pakistan. We recommend refresher courses and online webinars for updated information on menopause and its management.
评估妇产科医生针对绝经女性进行绝经激素治疗（MHT）的处方行为，评估其对MHT处方适应证的了解情况，并确定激素替代疗法（HRT）的障碍。
这是一项于2021年5月至2021年12月开展的横断面研究。参与者为妇产科专家（MCPS、FCPS、MRCOG）和资深专家。该工具在参考当代文献后制定，然后由专家进行了表面效度、内容效度和结构效度的验证。进行了预试验，经贾姆肖罗医科大学机构审查委员会批准后最终用于研究参与者。数据采用SPSS 22版进行分析。计算了李克特量表中各分类的均值和标准差。
大多数参与研究的妇科医生为潮热和阴道干燥开具HRT处方，在李克特量表（1 - 5）上的平均得分最高，接近4分。观察到针对其他绝经症状的处方较少。激素治疗特别合理的女性类别得分最高的是“卵巢早衰”（4.37），其次是“50岁前子宫切除加双侧卵巢切除”（4.23）。
巴基斯坦妇科医生在MHT管理策略上更为谨慎。大多数妇科医生在开具MHT处方时表现出良好且最新的信息，但巴基斯坦妇科医生在预防骨折、缓解焦虑/抑郁和体重增加方面的知识较少。我们建议开展进修课程和在线网络研讨会，以获取有关绝经及其管理的最新信息。
