Knowledge, Attitudes, and Practices Towards Hormone Replacement Therapy Among Women with Perimenopausal Syndrome: A Cross-Sectional Analysis in Quzhou, Zhejiang Province, China.

Background: Hormone replacement therapy (HRT) plays a critical role in managing perimenopausal syndrome, yet patients' knowledge, attitudes, and practices (KAP) toward HRT remain insufficiently understood. This study aimed to assess KAP toward HRT among patients with perimenopausal syndrome.

Patients and methods: This cross-sectional study conducted in Quzhou, Zhejiang Province, China, in February 2024 used a validated self-designed questionnaire to assess demographic characteristics and knowledge, attitudes, and practices (KAP) toward hormone replacement therapy (HRT). Structural equation modeling (SEM) was applied to examine the pathways among KAP dimensions.

Results: Among the 520 participants analyzed, 73.3% resided in urban areas, and 37.9% had used HRT for less than one year. The knowledge, attitude, and practice scores were 18.01±6.05 (possible range: 0-26), 37.56±5.07 (possible range: 10-50), and 6.07±1.70 (possible range: 0-8), respectively. There were significant positive correlations among knowledge, attitudes, and practices (all P < 0.001). SEM results showed that knowledge directly influenced attitudes (β = 0.499, P < 0.001) and practices (β = 0.125, P = 0.007), and that attitudes also directly influenced practices (β = 0.175, P = 0.005).

Conclusion: Patients exhibited moderate knowledge and relatively positive practices, though their attitudes toward HRT were suboptimal. The findings highlight the interrelationships among knowledge, attitudes, and practices regarding HRT, suggesting that educational efforts may play a key role in improving patient understanding and engagement.