Abstract
<title>Abstract</title> <p>Background Hormone therapy is an effective treatment for menopausal symptoms, but its use has changed substantially since the Women’s Health Initiative report. Long-term real-world data on hormone therapy and concomitant medication prescribing in Japan remain limited. Methods We conducted a 20-year retrospective database study using electronic prescription records from a tertiary university hospital in Japan. After describing overall prescription patterns among female patients, we focused on prescriptions issued to women aged 45–60 years with ICD-10-coded menopausal disorders. Annual trends in hormone therapy and six concomitant medication categories were examined using the Cochran–Armitage trend test. Patient-level logistic regression was used to explore factors associated with ever receiving hormone therapy. Results Among 132,523 prescriptions issued to 1,167 women with menopausal disorders, 268 women received hormone therapy. Hormone therapy prescribing declined significantly over time. Psychotropic medication prescribing did not show a corresponding increase in parallel with this decline. Kampo medicine showed a modest increase over time and was inversely associated with hormone therapy use in multivariable analysis. Conclusions In this single-centre Japanese university hospital database, hormone therapy prescribing among women with coded menopausal disorders declined over two decades. Concomitant medication patterns varied by drug category, and Kampo medicine showed only a modest increase. These findings describe real-world prescribing patterns and should be interpreted cautiously because treatment indications, symptom severity, and patient preferences were unavailable.</p>