AUSTIN, Texas—While all menopausal women are now facing the dilemma of whether or not to take hormone therapy, the decision for those with mobility impairments is even more difficult, says a University of Texas at Austin nursing researcher who has received federal funding to study the issue.
The research project, which will include 200 mid-life women with disabilities from around the country, is supported by a $150,000 grant from the National Institute of Nursing Research of the National Institutes of Health (NIH). Women with disabilities, including multiple sclerosis, spinal cord injuries, post-polio conditions and cerebral palsy, will participate in the study.
“Recent medical findings have made the decision of hormone therapy difficult for many women,” said Dr. Heather Becker of the School of Nursing. “But those with mobility impairments face special concerns because many enter menopause with decreased weight bearing and aerobic activity—making them at greater risk for osteoporosis and cardiovascular problems.”
In addition, women who experience temperature fluctuations as part of their disability may find menopausal hot flashes particularly troublesome, said Becker.
“While hormone therapy might control these symptoms, the benefits must be weighed against the potential for increased risk of blood clots, as well as the long-term risk of breast cancer,” Becker said. “Basically, menopausal women—who are also mobility impaired—have extra issues to consider.”
The aim of the study is to test a decision aid designed to assist menopausal women with mobility impairments in making informed choices about hormone therapy use. The researchers are looking at women with mobility impairments who are already taking hormones and trying to decide whether to continue or quit and those who are trying to decide if they should start taking hormones.
Findings from the study also will assist nurses and other providers in counseling women with mobility impairments about key health care decisions during menopause. Co-investigators from the School of Nursing are Drs. Alexa Stuifbergen and Sharon Dormire.
“We will not encourage or discourage women from using hormone therapy but rather help participants make an informed choice about this important decision,” Becker said.
Just a few years ago, hormones were widely believed to prolong youth and prevent heart disease. But the most recent studies have cast doubt over the belief that benefits of hormones outweigh the risks of breast cancer, blood clots, heart disease, stroke and dementia. Consequently, hormone use has dropped sharply.
Healthy People 2010, the American Nurses Association and the American College of Physicians have all recommended that mid-life women be counseled about the risks and benefits of hormone therapy.
“Menopausal women cannot wait until the scientific evidence becomes more decisive,” Becker said. “And, existing information about risks and benefits must be tailored to the special needs of women with mobility impairment.”
One of the key aspects of the grant is the requirement by the NIH to involve students in the research.
“The healthcare field is always changing, and it only changes and evolves because of the research,” said Tracie Jones, an undergraduate nursing student who is working on the study. “It is imperative for students to participate in research because odds are a nurse will be the first to recognize a flaw in the healthcare system. If a nurse has no knowledge or appreciation for research, the healthcare system will not improve and evolve as it has.”
For more information contact: Nancy Neff, School of Nursing, 512-471-6504.
