title: Psychological effects of hormone replacement therapy: a comparison of tibolone and a sequential estrogen therapy.
abstract: Hormone replacement therapy (HRT) is effective in alleviating vasomotor symptoms but the effect on psychological symptoms is less clear. This study aimed to compare the psychological effects of two regimens of HRT in perimenopausal women in a randomized, initially double-blind, controlled trial. Thirty-eight women reporting climacteric symptoms were randomly allocated into either oral conjugated equine estrogen 0.625 mg daily plus progestogen (norgestrel) 150 micrograms for the last 12 days of each 28 day cycle, or tibolone 2.5 mg/day for 28 days. They were assessed using standardized psychological assessments. There were no significant differences in changes from baseline between the two types of therapy. For both groups combined there were significant improvements compared with baseline in vasomotor symptoms in the first month, plus anxiety, sleep, memory and somatic dysfunction by the second and third months, but not in scores of depression. Log linear analysis of weekly scores showed that depression scores were significantly related to improvement in vasomotor scores independent of type of therapy and time on HRT. Memory problems were related to vasomotor symptoms independent of depression. No difference between the two types of therapy was found, nor any direct effect of HRT on anxiety or depression. The results support the domino theory, suggesting that psychological improvement follows alleviation of vasomotor symptoms.
authors.affiliation: Queen Margaret College, Edinburgh, UK.
authors.forename: L A
authors.initials: LA
authors.lastname: Ross
authors.forename: E M
authors.initials: EM
authors.lastname: Alder
authors.forename: E H
authors.initials: EH
authors.lastname: Cawood
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: A E
authors.initials: AE
authors.lastname: Gebbie
mesh_terms: D000368:Aged; D045930:Anabolic Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000517:prevention & control; D003863:Depression / Q000517:prevention & control; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy / Q000523:psychology*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009644:Norgestrel / Q000627:therapeutic use*; D009652:Norpregnenes / Q000627:therapeutic use*; D017697:Premenopause / Q000187:drug effects* / Q000502:physiology / Q000523:psychology*; D045167:Progesterone Congeners / Q000627:therapeutic use*; D011446:Prospective Studies
chemical_list: D045930:Anabolic Agents; D004966:Estrogens, Conjugated (USP); D009652:Norpregnenes; D045167:Progesterone Congeners; D009644:Norgestrel; C027385:tibolone