Negative mood changes during hormone replacement therapy: a comparison between two progestogens.
OBJECTIVE
The aim of this study was to compare side effects of medroxyprogesterone acetate and norethindrone acetate during postmenopausal hormone replacement therapy in women with and without a history of premenstrual syndrome.


METHODS
Fifty-one postmenopausal women were randomly selected in a double-blind crossover study. The women received 2 mg of estradiol continuously during five 28-day cycles and 10 mg of medroxyprogesterone or 1 mg of norethindrone sequentially for 12 days of each cycle. Daily symptom rating scales were kept.


RESULTS
The women showed cyclic changes, with negative mood and physical symptoms culminating during the late progestogen phase and positive mood during the estrogen-only phase. Symptoms declined with time but remained after 5 months. Women with a history of premenstrual syndrome responded strongly to both progestogens. Medroxyprogesterone acetate induced less negative and more positive mood symptoms than norethindrone in women with no history of premenstrual syndrome. In both groups medroxyprogesterone caused more physical symptoms than norethindrone.


CONCLUSIONS
The addition of medroxyprogesterone to estrogen is preferable to norethindrone with respect to mood symptoms in women without a history of premenstrual syndrome.
Björn
I
I
Department of Obstetrics and Gynecology, University Hospital of Umeå, Sweden.
Bixo
M
M
Nöjd
K S
KS
Nyberg
S
S
Bäckström
T
T
D000339:Affect / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008499:Medical Records; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects*; D008875:Middle Aged; D009640:Norethindrone / Q000009:adverse effects* / Q000031:analogs & derivatives; D000077563:Norethindrone Acetate; D011293:Premenstrual Syndrome; D045167:Progesterone Congeners / Q000009:adverse effects*
D045167:Progesterone Congeners; D000077563:Norethindrone Acetate; D017258:Medroxyprogesterone Acetate; D009640:Norethindrone