title: A multicenter, open-label study to evaluate satisfaction and menopausal quality of life in women using transdermal estradiol/norethindrone acetate therapy for the management of menopausal signs and symptoms.
abstract: OBJECTIVE
  This multicenter, open-label, single-arm study evaluated subject satisfaction and improvements in menopausal quality of life among menopausal women using the CombiPatch transdermal system consisting of 17beta-estradiol 0.05 mg plus norethindrone acetate 0.14 mg in a matrix patch formulation.
  
  
  METHODS
  The 193 postmenopausal women between the ages of 45 and 65 years who comprised the modified intent-to-treat population (at least one patch and one efficacy assessment) were required to have reported at least five daily moderate-to-severe hot flashes and episodes of nocturnal sweating upon study entry for at least 1 month and applied one patch twice a week for 12 weeks. At weeks 0, 6, and 12, the women completed the Menopause-Specific Quality of Life (MENQOL) Questionnaire and, as a secondary study outcome, reported the scale of their application site discomfort. During weeks 1-12, they also kept diary records of number and severity of hot flashes and four other menopausal symptoms. Skin tolerance and adherence of the transdermal system were evaluated at weeks 6 and 12 by qualified evaluators. At week 6 and the end of the study, both subjects and physicians rated their satisfaction with the system.
  
  
  RESULTS
  Among women in the modified intent-to-treat population, transdermal 17beta-estradiol plus norethindrone acetate significantly reduced the mean daily number of moderate-to-severe hot flashes experienced by women from 4.1 at week 1 to 0.6 at week 12 (p < 0.0001). The mean ratings of headache severity, insomnia, and vaginal irritation/dryness also improved significantly by week 6 and were maintained at week 12. At week 12, 92.4% of the subjects and 97.3% of the physicians reported that they were 'satisfied' or 'very satisfied' with the transdermal hormone delivery system.
  
  
  CONCLUSIONS
  The results of this study compare favorably with previous placebo-controlled studies of transdermal hormone therapy in managing menopausal signs and symptoms. Furthermore, quality of life was significantly improved by the transdermal hormone therapy system, and both subjects and physicians reported high levels of satisfaction.
authors.affiliation: Florida GYN Group, Orlando, Florida, USA.
authors.forename: George
authors.initials: G
authors.lastname: Adler
authors.forename: Douglas
authors.initials: D
authors.lastname: Young
authors.forename: Ron
authors.initials: R
authors.lastname: Galant
authors.forename: Laura
authors.initials: L
authors.lastname: Quinn
authors.forename: Mary Sue
authors.initials: MS
authors.lastname: Witchger
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Maki
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D004338:Drug Combinations; D004958:Estradiol / Q000008:administration & dosage*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy*; D006801:Humans; D006945:Hyperhidrosis / Q000188:drug therapy; D008875:Middle Aged; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077563:Norethindrone Acetate; D017060:Patient Satisfaction; D017698:Postmenopause; D011788:Quality of Life; D012102:Reproductive Control Agents / Q000008:administration & dosage*
chemical_list: D004338:Drug Combinations; D012102:Reproductive Control Agents; D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone