title: Climacteric symptom control after the addition of low-dose esterified conjugated estrogens to raloxifene standard doses.
abstract: BACKGROUND
  Hormone therapy (HT) is one the best options for climacteric symptom control; however when women are switched to raloxifene, after several years of HT, they restart with symptoms.
  
  
  OBJECTIVE
  To evaluate the effect of the addition of low-dose esterified conjugated estrogens to the conventional dose of raloxifene in the control of climacteric symptoms.
  
  
  METHODS
  14 healthy postmenopausal patients were studied. Climacteric symptoms were evaluated at baseline and 3 months after the beginning of treatment by the Kupperman's index (KI) and by the sum of the symptom evaluations carried out with an analog visual scale called SUMEVA. In all the anthropometric variables were documented, as well as time since menopause and endometrial thickness. At random they were distributed in some of the following groups: I) Raloxifene 60 mg/day (n=7) and II) Raloxifene 60 mg/day plus esterified conjugated estrogens 0.312 mg/day (n=7).
  
  
  METHODS
  Differences among the groups, as well as those among baseline and those at the end of treatment, were determined by student's t test for independent samples and paired samples respectively.
  
  
  RESULTS
  There were no differences in anthropometric variables, nor in the time since menopause. After three months of treatment the libido alterations vertigo and vaginal dryness were significantly greater in group I. In group II a significant decrease in hot flushes, insomnia, nervousness, vaginal dryness, KI, and SUMEVA were found, as was a significant increase in endometrial thickness.
  
  
  CONCLUSIONS
  The treatment that is proposed in this study can constitute a temporary alternative during the period of transition from HT to raloxifene.
authors.affiliation: Gynecologic Endocrinology Department Hospital de Ginecología y Obstetricia Luis Castelazo Ayala, DF México. scarranzal@mexis.com
authors.forename: Sebastián
authors.initials: S
authors.lastname: Carranza-Lira
authors.forename: Ana Luz MacGregor
authors.initials: AL
authors.lastname: Gooch
authors.forename: Nadia
authors.initials: N
authors.lastname: Saldivar
authors.forename: Max Saráchaga
authors.initials: MS
authors.lastname: Osterwalder
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001007:Anxiety / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage*; D005260:Female; D019584:Hot Flashes / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D011788:Quality of Life; D020849:Raloxifene Hydrochloride / Q000008:administration & dosage*; D020845:Selective Estrogen Receptor Modulators / Q000008:administration & dosage*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D016387:Women's Health
chemical_list: D004966:Estrogens, Conjugated (USP); D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride