title: Long-term effects of two different continuous combined regimens of hormone replacement therapy on well-being.
abstract: Our aim was to compare the effect on well-being of two different continuous combined hormone replacement therapies (HRT) in women starting treatment ('starters') and women switching from mainly sequential HRT ('switchers'). The design was a randomized, double-blind, 1-year, prospective study, including 249 postmenopausal women treated with 0.625 mg conjugated estrogen (CE)/5 mg medroxyprogesterone acetate (MPA) or 2 mg estradiol/1 mg norethisterone acetate (NETA) continuously. The main outcome measure was well-being, reported daily on a validated symptom scale during treatment cycles 1, 2, 6 and 13. Both treatment groups, starters and switchers, improved significantly in episodes of sweating during the first 6 months (p < 0.05). Women treated with estradiol/NETA experienced more breast tenderness compared to women using CE/MPA during the whole study period (p < 0.001), whereas there were no differences in negative mood symptoms between treatment groups. Starters experienced improved well-being during the whole study, whereas switchers experienced a transient improvement during the first 2 months. Overall, negative mood symptoms were more frequently reported by women with a history of premenstrual syndrome (PMS) (p < 0.05). Progestogen side-effects were more pronounced with estradiol/NETA than with CE/MPA combinations. Individual factors, such as previous PMS and previous HRT use, should be taken into consideration when prescribing HRT.
authors.affiliation: Department of Clinical Science, Obstetrics and Gynecology, University of Umeå, Umeå, Sweden.
authors.forename: I-S
authors.initials: IS
authors.lastname: Odmark
authors.forename: T
authors.initials: T
authors.lastname: Bäckström
authors.forename: B
authors.initials: B
authors.lastname: Jonsson
authors.forename: M
authors.initials: M
authors.lastname: Bixo
mesh_terms: D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004958:Estradiol / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D011446:Prospective Studies; D011788:Quality of Life; D013548:Sweden
chemical_list: D004966:Estrogens, Conjugated (USP); D004958:Estradiol; D000077563:Norethindrone Acetate; D017258:Medroxyprogesterone Acetate; D009640:Norethindrone