title: Relief of vasomotor symptoms and vaginal atrophy with lower doses of conjugated equine estrogens and medroxyprogesterone acetate.
abstract: OBJECTIVE
  To evaluate the efficacy of lower doses of conjugated equine estrogens (CEE) plus medroxyprogesterone acetate (MPA) for relieving vasomotor symptoms and vaginal atrophy.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled trial (the Women's Health, Osteoporosis, Progestin, Estrogen study).
  
  
  METHODS
  Study centers across the United States.
  
  
  METHODS
  Two thousand, six hundred, seventy-three healthy, postmenopausal women with an intact uterus, including an efficacy-evaluable population (n = 241 at baseline).
  
  
  METHODS
  Patients received for 1 year (13 cycles; in milligrams per day) CEE, 0.625; CEE, 0.625 and MPA, 2.5; CEE, 0.45; CEE, 0.45 and MPA, 2.5; CEE, 0.45 and MPA, 1.5; CEE, 0.3; CEE, 0.3 and MPA, 1.5; or placebo.
  
  
  METHODS
  Number and severity of hot flushes and Papanicolaou smear with vaginal maturation index (VMI) to assess vaginal atrophy.
  
  
  RESULTS
  In the efficacy-evaluable population, reduction in vasomotor symptoms was similar with CEE of 0.625 mg/d and MPA of 2.5 mg/d (the most commonly prescribed doses) and all lower combination doses. CEE of 0.625 mg/d alleviated hot flushes more effectively than the lower doses of CEE alone. VMI improved in all active treatment groups.
  
  
  CONCLUSIONS
  Lower doses of CEE plus MPA relieve vasomotor symptoms and vaginal atrophy as effectively as commonly prescribed doses.
authors.affiliation: Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, Ohio, USA. utian@menopause.org
authors.forename: W H
authors.initials: WH
authors.lastname: Utian
authors.forename: D
authors.initials: D
authors.lastname: Shoupe
authors.forename: G
authors.initials: G
authors.lastname: Bachmann
authors.forename: J V
authors.initials: JV
authors.lastname: Pinkerton
authors.forename: J H
authors.initials: JH
authors.lastname: Pickar
mesh_terms: D000328:Adult; D000818:Animals; D001284:Atrophy; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005483:Flushing / Q000453:epidemiology / Q000503:physiopathology*; D006736:Horses; D006801:Humans; D015994:Incidence; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D045167:Progesterone Congeners / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D012720:Severity of Illness Index; D014621:Vagina / Q000187:drug effects* / Q000473:pathology* / Q000503:physiopathology
chemical_list: D004966:Estrogens, Conjugated (USP); D045167:Progesterone Congeners; D017258:Medroxyprogesterone Acetate