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Yali A. Bair, BA, Ellen B. Gold, PhD, Gail A. Greendale, MD, Barbara Sternfeld, PhD, Shelley R. Adler, PhD, Rahman Azari, PhD and Martha Harkey, PhD

Yali A. Bair and Ellen B. Gold are with the Department of Epidemiology and Preventive Medicine, University of California, Davis. Gail A. Greendale is with the Division of Geriatrics, University of California, Los Angeles. Barbara Sternfeld is with the Department of Epidemiology and Biostatistics, Division of Research, Kaiser Permanente, Oakland, Calif. Shelley R. Adler is with the Department of Anthropology, History and Social Medicine, University of California, San Francisco. Rahman Azari is with the Department of Statistics, University of California, Davis. Martha Harkey is with the Department of Medical Pharmacology and Toxicology, School of Medicine, University of California, Davis.

Correspondence: Requests for reprints should be sent to Yali A. Bair, BA, Department of Epidemiology and Preventive Medicine, University of California, Davis, One Shields Ave, TB 168, Davis, CA 95616 (e-mail: yabair{at}ucdavis.edu).

Objectives. We estimated the prevalence and longitudinal correlates of use of complementary and alternative medicine (CAM) at midlife among participants of the Study of Women’s Health Across the Nation (SWAN).

Methods. Multiple logistic regression was used to evaluate the relationship between baseline survey–reported symptoms and use of herbal, spiritual, and physical manipulation therapies 1 year later.

Results. Almost half of all women had used CAM in the past year. Baseline psychological symptoms were associated with subsequent use of spiritual therapies among White and Chinese women. Baseline CAM use was a major predictor of subsequent use in White, Japanese, and Chinese women.

Conclusions. Baseline CAM use, rather than presence of symptoms, was the major predictor of subsequent CAM use. Premenopausal health behaviors are important determinants of choice of therapy during midlife.

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