: Questionnaires were mailed to a random sample of Lebanese gynecologists (n = 178). The questionnaires solicited practice patterns of HT for postmenopausal women and information provided while counseling before and after the WHI study. Descriptive statistical methods were used to evaluate the responses.
: Questionnaires were returned by 140 physicians (78.7 % ), 93.6 % of whom were aware of the WHI study. More than 90 % of respondents routinely offered HT prior to the study. Of the 85.6 % who used a combination of oral estrogen and progesterone (E/P), 40.0 % used conjugated equine estrogen (CEE) and medroxyprogesterone acetate (MPA). Around 67 % of gynecologists reported a change in their therapeutic approach after the study. The main changes were: not offering CEE + MPA (27.3 % ), prescribing CEE + MPA to a select group of patients (37.5 % ), using other forms of HT (56.8 % ), or abandoning any form of HT (6.8 % ). Other practice modifications included a shift to the use of tibolone (18.2 % ) or alternative therapies (29.5 % ). Whereas 76.2 % of physicians counseled their patients about a decreased risk of cardiovascular events with HT prior to WHI study, only 34.1 % continued to do so after the study (p < 0.001). The percentage of gynecologists that inform their patients of an increased risk of breast cancer on HT rose from 45.2 to 73.2 % (p = 0.018). Almost 51 % of gynecologists allow their patients to participate in decision making regarding the type of HT, 42.4 % would choose for their patients after counseling, while 6.8 % of physicians do not counsel their patients in order not to confuse them.
: In a representative sample of Lebanese gynecologists, there was a significant change in physicians’ attitudes towards HT following the publication of the WHI study.