Journal of applied research in intellectual disabilities : JARID · 2026
Disparities in Hormone Replacement Therapy Prescribing for Women With Intellectual Disabilities.
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Bontoft Charis, Sawhney Indermeet, Zia Asif, Adams Danielle
Аннотация
BACKGROUND: People with intellectual disabilities who menstruate are underrepresented in menopause research and care.
METHODS: A mixed-methods service evaluation was conducted in one NHS Trust. In Phase 1, prescribing data from electronic health records for women aged 40-79 with intellectual disabilities (n = 149) was extracted and statistically compared to estimates for the general population. Phase 2 comprised a focus group with psychiatrists (n = 6) and an interview with a GP (n = 1); data were analysed using framework analysis.
FINDINGS: HRT was prescribed to 3.3% of people with intellectual disabilities, versus 17.2% in the general population, indicating significantly lower prescribing (p < 0.0001). Qualitative themes highlighted low clinician awareness, diagnostic overshadowing, concerns about monitoring and system-level issues. Facilitators included psychiatrist advocacy, proactive carers and clearer primary-to-secondary care collaboration.
CONCLUSIONS: Women with LD were substantially less likely to receive HRT, suggesting a marked inequity in menopause care. Recommendations are made to improve recognition, treatment access and outcomes.
METHODS: A mixed-methods service evaluation was conducted in one NHS Trust. In Phase 1, prescribing data from electronic health records for women aged 40-79 with intellectual disabilities (n = 149) was extracted and statistically compared to estimates for the general population. Phase 2 comprised a focus group with psychiatrists (n = 6) and an interview with a GP (n = 1); data were analysed using framework analysis.
FINDINGS: HRT was prescribed to 3.3% of people with intellectual disabilities, versus 17.2% in the general population, indicating significantly lower prescribing (p < 0.0001). Qualitative themes highlighted low clinician awareness, diagnostic overshadowing, concerns about monitoring and system-level issues. Facilitators included psychiatrist advocacy, proactive carers and clearer primary-to-secondary care collaboration.
CONCLUSIONS: Women with LD were substantially less likely to receive HRT, suggesting a marked inequity in menopause care. Recommendations are made to improve recognition, treatment access and outcomes.