Insights into Singaporean Physicians’ Knowledge and Attitudes on Menopause Hormone Therapy

Abstract

Objectives: To evaluate physicians’ knowledge and attitudes in Singapore regarding menopause hormonal therapy (MHT). Methods: We conducted a cross-sectional survey of 186 physicians practicing in Singapore, including 113 in Family Medicine and 73 in Obstetrics and Gynaecology (O&G). Knowledge was assessed using 21 questions: five questions each on indications, contraindications and risks, and six clinical scenario questions. Attitudes were assessed using five questions: confidence in prescribing, beliefs about the necessity of MHT, whether they would recommend it for patients or family, and concerns about its safety profile. Data were analyzed using descriptive statistics. Comparisons of knowledge and attitudes across demographic variables and specialties were performed using t tests for continuous variables and chi-squared tests for categorical variables. Results: Forty point three percent of physicians were unaware that MHT is used to prevent postmenopausal osteoporosis. Sixty-six point one percent and 30.6% of physicians, respectively, were unaware that patients on MHT are at a higher risk of gallbladder disease and stroke. Fifty-two point two percent would have chosen non-hormonal treatments for patients with premature ovarian insufficiency. Most physicians expressed a lack of confidence in prescribing MHT (74.2%), with a significant difference (P < 0.001) between the specialties (58.9% of O&G physicians vs. 84.1% of Family Medicine physicians). More than half (61.3%) of physicians expressed safety concerns about MHT. Conclusions: Information about MHT continues to evolve, emphasizing the importance of keeping physicians updated. Knowledge gaps vary among specialties. Improving physicians’ knowledge by targeted educational interventions should help bolster confidence.