Well-being at onset of hormone replacement therapy: comparison between two continuous combined regimens
2004 (English)In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 7, no 1, 92-102 p.Article in journal (Refereed) Published
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.
Place, publisher, year, edition, pages
2004. Vol. 7, no 1, 92-102 p.
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, Gynecology and Reproductive Medicine
Research subject Obstetrics and Gynaecology
IdentifiersURN: urn:nbn:se:umu:diva-9362DOI: 10.1080/13697130310001651526PubMedID: 15259288OAI: oai:DiVA.org:umu-9362DiVA: diva2:149033