{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:02:29Z","timestamp":1790928149872,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","award":["PD20\u20100068"],"award-info":[{"award-number":["PD20\u20100068"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Vetenskapsr\u00e5det","doi-asserted-by":"publisher","award":["2024\u201000460"],"award-info":[{"award-number":["2024\u201000460"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","award":["22 2322Pj"],"award-info":[{"award-number":["22 2322Pj"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019032","name":"Regionala Forskningsr\u00e5det Uppsala\/\u00d6rebro","doi-asserted-by":"publisher","award":["1004791"],"award-info":[{"award-number":["1004791"]}],"id":[{"id":"10.13039\/100019032","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019032","name":"Regionala Forskningsr\u00e5det Uppsala\/\u00d6rebro","doi-asserted-by":"publisher","award":["977562"],"award-info":[{"award-number":["977562"]}],"id":[{"id":"10.13039\/100019032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Menopausal hormone therapy (MHT) is used to manage menopausal symptoms. Dispensing patterns are influenced by evolving guidelines, clinical practice, and public perceptions, which have shifted considerably over the past two decades. This study aims to describe patterns and age\u2010specific trajectories of MHT dispensing in Sweden in a closed cohort of women aged 45\u201360\u2009years at baseline, followed from 2006 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>A population\u2010based closed cohort study linking several Swedish national health registers was performed. A total of 951\u2009455 women aged 45\u201360\u2009years residing in Sweden were included on January 1, 2006, and followed up until December 31, 2020. MHT dispensing was examined through three approaches: 1) local or no MHT versus systemic MHT, 2) oral versus transdermal estrogen, and 3) based on progestogen type and administration route. Analyses were also stratified by age at baseline (45\u201349, 50\u201354, 55\u201360\u2009years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Systemic MHT dispensing was 9.6% in 2006 and 3.8% in 2020, while 6.7% and 16.7% used local MHT, respectively. The oldest age group consistently dispensed systemic MHT to a greater extent through the years. Oral estrogen dominated, although relative transdermal estrogen use increased modestly toward the end of follow\u2010up. Dispensing of systemic MHT was less common among women born outside Europe, while dispensing of transdermal estrogen, compared to oral, was higher among those with higher education and income. Synthetic progestogens remained the most common type of progestogen, whereas dispensing of bioidentical progesterone\/dydrogesterone and hormonal intrauterine devices was rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large, population\u2010based, closed cohort of women in Sweden, dispensing of systemic MHT declined with increasing age, while local MHT increased. Dispensing patterns, including route of estrogen administration and type of progestogen, varied by age cohort and sociodemographic characteristics. These findings illustrate how MHT dispensing is shaped by aging, cohort effects, evolving clinical practices, and updated guidelines, as well as by social determinants of health. Overall, the results underscore the importance of continued monitoring of MHT dispensing and efforts to ensure that prescribing remains evidence\u2010based and equitable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70225","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:30:38Z","timestamp":1779186638000},"page":"1454-1467","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Patterns of menopausal hormone therapy dispensing over 15\u2009years\u2014A Swedish register\u2010based cohort study"],"prefix":"10.1111","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3246-5440","authenticated-orcid":false,"given":"Rebecca","family":"G\u00f6tze Eriksson","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"S\u00f6derquist","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Wikman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego Hernan","family":"Giunta","sequence":"additional","affiliation":[{"name":"Centre for Pharmacoepidemiology, Division of Clinical Epidemiology (KEP), Department of Medicine Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Sundstr\u00f6m Poromaa","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2253-4682","authenticated-orcid":false,"given":"Evangelia","family":"Elenis","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Department of Obstetrics &amp; Gynecology Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica Lind\u00e9n","family":"Hirschberg","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Gynecology and Reproductive Medicine Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkistis","family":"Skalkidou","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros I.","family":"Iliadis","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Department of Obstetrics &amp; Gynecology Uppsala University Hospital  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.180"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.8063"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002978.pub2"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199109123251102"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-12-1016"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/13697130400001786"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.3.321"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001282"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2019.1593357"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2021.02.003"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2014.07.002"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.11217"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000002028"},{"key":"e_1_2_14_15_1","unstructured":"Svensk f\u00f6rening f\u00f6r obstetrik och gynekologi.SFOG\u2010r\u00e5d f\u00f6r menopausalhormonbehandling 2019 uppdaterad version 2021.2021. Accessed December 18 2024.https:\/\/www.sfog.se\/media\/337272\/mht\u2010bakgrund\u2010210121.pdf"},{"key":"e_1_2_14_16_1","unstructured":"Socialstyrelsen.Kartl\u00e4ggning av v\u00e5rd och behandling vid klimakteriebesv\u00e4r ur perspektivet j\u00e4mlik v\u00e5rd.2020.https:\/\/www.socialstyrelsen.se\/globalassets\/sharepoint\u2010dokument\/artikelkatalog\/ovrigt\/2020\u20101\u20106568.pdf"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2023.107787"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13293-025-00720-9"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X713045"},{"key":"e_1_2_14_20_1","unstructured":"Socialstyrelsen.2023.Registers. Accessed December 10 2024.https:\/\/www.socialstyrelsen.se\/en\/statistics\u2010and\u2010data\/registers\/"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-025-01221-0"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-019-00511-8"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-016-0117-y"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1294"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-450"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-017-0316-1"},{"key":"e_1_2_14_27_1","unstructured":"ATCDDD \u2010 ATC\/DDD Index. Accessed December 11 2024.https:\/\/atcddd.fhi.no\/atc_ddd_index\/"},{"key":"e_1_2_14_28_1","unstructured":"Defined Daily Dose (DDD). Accessed September 16 2024.https:\/\/www.who.int\/tools\/atc\u2010ddd\u2010toolkit\/about\u2010ddd"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5366"},{"key":"e_1_2_14_30_1","unstructured":"ICD\u201010 Version: 2019. Accessed September 17 2024.https:\/\/icd.who.int\/browse10\/2019\/en"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5186"},{"key":"e_1_2_14_32_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2023-078784","article-title":"Contemporary menopausal hormone therapy and risk of cardiovascular disease: Swedish nationwide register based emulated target trial","volume":"387","author":"Johansson T","year":"2024","journal-title":"BMJ"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/GME.0000000000001938"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2018.1446931"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2015.1129166"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-2236"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2025.108263"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000402.pub4"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2016.05.013"},{"key":"e_1_2_14_40_1","unstructured":"National Institute for Health and Care Excellence.Menopause: identification and management.2015. Accessed March 14 2025.https:\/\/www.nice.org.uk\/guidance\/ng23\/resources\/menopause\u2010identification\u2010and\u2010management\u2010pdf\u20101837330217413"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184070"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70225","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T05:17:52Z","timestamp":1783833472000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":40,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/aogs.70225"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70225","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]},"assertion":[{"value":"2025-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}