Decade-long use of continuous combined hormone replacement therapy is associated with better health-related quality of life in postmenopausal women, as measured by the generic 15D instrument.
OBJECTIVE
To examine quality of life after a decade of continuous combined hormone replacement therapy.


METHODS
The 15D, a generic health-related quality-of-life (HRQoL) instrument, was used to evaluate trends in HRQoL in women who used continuous combined hormone replacement therapy (ccHRT; Indivina, Orion Pharma, Finland) for up to nine years. These women had a mean age of 56 years of age at the start of therapy. Control data on HRQoL were obtained from age-matched women participating in Finnish population health surveys.


RESULTS
Relative to controls, ccHRT was associated with significantly better HRQoL after six and nine years of treatment. Dose minimization at 8.5 years was not associated with a decline in HRQoL in the ensuing six months. One year after discontinuation of ccHRT there was evidence of a decline in HRQoL in women who discontinued ccHRT as planned, whereas HRQoL was maintained in women who had continued or resumed ccHRT during the one-year post-study follow-up. The benefits of ccHRT were apparent in multiple dimensions of the 15D, being largest and most robustly reproduced in the dimension 'discomfort and symptoms'. It is conjectured that the effectiveness of ccHRT in relieving symptoms of menopause may have contributed to the improved HRQoL scores registered in other dimensions, in addition to any direct effects of ccHRT on specific aspects of those other dimensions.


CONCLUSIONS
These data indicate that up to 10 years of low-dose ccHRT has sustained value in the enhancement of HRQoL when used by women for whom relief of symptoms of menopause and control of bleeding are primary objectives of treatment.
Ylikangas
Stiina
S
Orion Pharma, Espoo, Finland. stiina.ylikangas@orionpharma.com
Sintonen
Harri
H
Heikkinen
Jorma
J
D000328:Adult; D000368:Aged; D004958:Estradiol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008875:Middle Aged; D017698:Postmenopause / Q000187:drug effects*; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires
D004966:Estrogens, Conjugated (USP); D004958:Estradiol; D017258:Medroxyprogesterone Acetate