title: Menopausal symptoms after the discontinuation of long-term hormone replacement therapy in women under 60: a 3-year follow-up.
abstract: BACKGROUND
  Prescriptions for hormone replacement therapy (HRT) declined following the publication of the Women's Health Initiative study. The number of women who experience recurrence of menopausal symptoms after discontinuation of long-term HRT (LT-HRT), the length of time these symptoms last and the preferred alternative treatments remain unknown.
  
  
  METHODS
  This prospective 3-year follow-up study analyses the prevalence and intensity of menopausal symptoms that occur in young postmenopausal women who discontinued LT-HRT. Symptoms were evaluated using the Menopause Rating Scale.
  
  
  RESULTS
  Women (254) who discontinued LT-HRT (mean use: 6.9 ± 2.3 years) were recruited. Mean age at menopause was 48.1 ± 3.4 years. Mean age at discontinuation was 56.8 ± 3.7 years. 23% of the women were lost to follow-up. Of the remaining 196 women, 93% experienced a recurrence of menopausal symptoms within the first year, 25% resumed low-dose HRT, 62% used vaginal estrogens, 54% used phytoestrogens, and 2% used alternative therapies. A decrease in symptom prevalence and intensity was observed during the 3-year follow-up.
  
  
  CONCLUSIONS
  Symptoms re-appeared in a significant proportion of patients within the first year after discontinuation of LT-HRT. However, after 3 years, the majority of these women were asymptomatic. Patients who discontinue LT-HRT may require a more detailed follow-up immediately after the discontinuation of treatment.
authors.affiliation: Department of Gynaecology and Obstetrics, University of Rome 'Sapienza', Italy. giuseppina.perrone@uniroma1.it
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Perrone
authors.forename: Oriana
authors.initials: O
authors.lastname: Capri
authors.forename: Paola
authors.initials: P
authors.lastname: Galoppi
authors.forename: Francesca R
authors.initials: FR
authors.lastname: Patacchioli
authors.forename: Elisa
authors.initials: E
authors.lastname: Bevilacqua
authors.forename: Maria G
authors.initials: MG
authors.lastname: de Stefano
authors.forename: Roberto
authors.initials: R
authors.lastname: Brunelli
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy / Q000009:adverse effects* / Q000379:methods*; D006801:Humans; D008593:Menopause / Q000187:drug effects* / Q000502:physiology*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013375:Substance Withdrawal Syndrome / Q000209:etiology*