Well-being at onset of hormone replacement therapy : comparison between two continuous combined regimens

• Objectives To compare the effect on well-being of two continuous combined hormone replacement therapies (HRTs) in women starting treatment (‘starters’) and women switching from mainly sequential HRT (‘switchers’). Methods This was a randomized, double-blind, 1-month trial, in which 249 postmenopausal women were treated with either conjugated estrogen plus medroxyprogesterone acetate (CE/MPA 0.625 mg/5 mg) or 17β-estradiol plus norethisterone acetate (E2/NETA 2 mg/1 mg) continuously. Twelve items for measuring climacteric symptoms and well-being were reported daily on a validated symptom scale. Results Women taking CE/MPA reported lower scores for breast tenderness (p = 0.005), depression (p = 0.019), irritability (p = 0.004) and tension (p = 0.048), compared with women taking E2/NETA. Compared with pretreatment, both groups developed side-effects during the first week: breast tenderness, swelling and depression (p < 0.05). Starters, but also switchers, improved in sweats (p < 0.001 and p = 0.030). Compared with pretreatment ratings, switchers reported higher scores for breast tenderness (p < 0.001), depression (p = 0.050) and negative effects on daily life (p < 0.001), whereas starters reported only physical side-effects (p < 0.05). A history of premenstrual syndrome (PMS) predicted high scores for swelling (p = 0.023), depression (p = 0.024), tension (p = 0.009), irritability (p = 0.027), headache (p < 0.001) and negative effects on daily life (p < 0.001). Conclusions CE/MPA 0.625 mg/5 mg is better tolerated than E2/NETA 2 mg/1 mg, and starters react differently from switchers. Side-effects occur more quickly than benefits with HRT, and are more frequent in women with previous PMS.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

Keyword

breast/physiopathology

contraceptive Agents

female/therapeutic use

depression/drug therapy/psychology

double-Blind method

edema/physiopathology

estrogen replacement therapy/*methods

estrogens/therapeutic use

estrogens

conjugated (USP)/therapeutic use

female

humans

irritable mood

medroxyprogesterone 17-acetate/therapeutic use

middle aged

norethindrone/*analogs & derivatives/therapeutic use

pain/physiopathology

postmenopause/physiology/*psychology

predictive value of tests

prospective studies

quality of life

sleep initiation and maintenance disorders/drug therapy/psychology

sweating/drug effects/physiology

Obstetrics and gynaecology

Obstetrik och gynekologi

obstetrik och gynekologi

Obstetrics and Gynaecology

Publication and Content Type

ref (subject category)

art (subject category)