title: Medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes: a 1-year randomized double-blind trial following premenopausal ovariectomy.
abstract: Oestrogen therapy is the gold standard treatment for hot flushes/night sweats, but it and oestrogen/progestin are not suitable for all women. MPA (medroxyprogesterone acetate) reduces hot flushes, but its effectiveness compared with oestrogen is unknown. In the present study, oral oestrogen [CEE (conjugated equine oestrogen)] and MPA were compared for their effects on hot flushes in a planned analysis of a secondary outcome for a 1-year randomized double-blind parallel group controlled trial in an urban academic medical centre. Participants were healthy menstruating women prior to hysterectomy/ovariectomy for benign disease. A total of 41 women {age, 45 (5) years [value is mean (S.D.)]} were enrolled; 38 women were included in this analysis of daily identical capsules containing CEE (0.6 mg/day) or MPA (10 mg/day). Demographic variables did not differ at baseline. Daily data provided the number of night and day flushes compared by group. The vasomotor symptom day-to-day intensity change was assessed by therapy assignment. Hot flushes/night sweats were well controlled in both groups, one occurred on average every third day and every fourth night. Mean/day daytime occurrences were 0.363 and 0.187 with CEE and MPA respectively, but were not significantly different (P=0.156). Night sweats also did not differ significantly (P=0.766). Therapies were statistically equivalent (within one event/24 h) in the control of vasomotor symptoms. Day-to-day hot flush intensity decreased with MPA and tended to remain stable with CEE (P<0.001). In conclusion, this analysis demonstrates that MPA and CEE are equivalent and effective in the control of the number of hot flushes/night sweats immediately following premenopausal ovariectomy.
authors.affiliation: Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology and Metabolism, Department of Medicine, University of British Columbia and Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. jerilynn.prior@vch.ca
authors.forename: Jerilynn C
authors.initials: JC
authors.lastname: Prior
authors.forename: Jason D
authors.initials: JD
authors.lastname: Nielsen
authors.forename: Christine L
authors.initials: CL
authors.lastname: Hitchcock
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Williams
authors.forename: Yvette M
authors.initials: YM
authors.lastname: Vigna
authors.forename: Charmaine B
authors.initials: CB
authors.lastname: Dean
mesh_terms: D000328:Adult; D003280:Contraceptives, Oral, Synthetic / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D005260:Female; D019584:Hot Flashes / Q000517:prevention & control*; D006801:Humans; D016014:Linear Models; D008525:Medroxyprogesterone / Q000627:therapeutic use*; D008875:Middle Aged; D010052:Ovariectomy; D017697:Premenopause
chemical_list: D003280:Contraceptives, Oral, Synthetic; D004966:Estrogens, Conjugated (USP); D008525:Medroxyprogesterone