Association Between Hormone Therapy and Health-Related Quality of Life in Postmenopausal Korean Women: A Nationwide Cross-Sectional Study Using 2005–2009 KNHANES Data

Background: Hormone therapy (HT) is an effective treatment for relieving menopausal symptoms; however, its association with health-related quality of life (HRQoL) in Asian populations remains insufficiently characterized. Objective: The aim of this study was to examine the association between HT use and HRQoL dimensions in postmenopausal Korean women using nationally representative data from 2005, 2007, 2008, and 2009. Methods: In this cross-sectional study, we analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2005, 2007, 2008, and 2009. Postmenopausal women aged 40–65 years were included (n = 2460). HRQoL was assessed using the EuroQol 5-Dimension 3-Level (EQ-5D-3L) instrument. Survey-weighted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to determine the association between HT use and each EQ-5D dimension, adjusting for age. Results: Of the 2460 participants, 464 (18.9%) were HT users. HT use was significantly more common among women with higher education levels (p < 0.001) and higher household income (p < 0.001). The weighted mean EQ-5D index was significantly higher among HT users (0.911, 95% CI: 0.902–0.921) than non-users (0.894, 95% CI: 0.889–0.900; p < 0.05). In age-stratified analyses, significant differences were observed between women aged <55 years (p < 0.05) and those aged ≥60 years (p < 0.05). The EQ-5D index was positively associated with HT duration in women aged <55 and ≥60 years (p for trend < 0.05). In age-adjusted, dimension-specific analyses, HT use was associated with lower odds of reporting problems across all five EQ-5D dimensions (all p < 0.001), with the strongest association observed for usual activities (OR = 0.719, 95% CI: 0.715–0.722). Conclusions: In this nationally representative sample of postmenopausal Korean women, HT use was associated with more favorable HRQoL outcomes, particularly in the usual activities domain, with patterns varying by age and BMI subgroups. These findings support individualized menopausal counseling that incorporates quality-of-life considerations into clinical decision-making.