title: The effects of progesterone selection on psychological symptoms in hormone replacement therapy.
abstract: OBJECTIVE
  The aim of this study is to evaluate the effects of hormone replacement therapy using dienogest and medroxyprogesterone acetate on psychological symptoms in perimenopausal and postmenopausal women.
  
  
  METHODS
  A total of 73 patients who sought treatment at the menopause units of the authors' gynecology and obstetrics clinics between of November 2003 and October 2004 complaining of vasomotor symptoms were included in the study prospectively. The cases were divided into two groups: Group I (37 patients) was given 2 mg estradiol valerate and 2 mg dienogest, and Group II (36 patients) was given 2 mg estradiol valerate and 10 mg medroxyprogesterone acetate. The groups' results in months 0 and 6 were compared through the evaluation of vasomotor and psychological symptom levels.
  
  
  RESULTS
  No significant difference was found between the groups when the initial levels of vasomotor and psychological symptom subtypes were compared (p = 0.16). It was observed that all the psychological symptoms decreased in the 6th month in the group using dienogest in comparison with the initial situation, and that psychological symptoms increased in the group using medroxyprogesterone acetate in the evaluation performed in the 6th month compared with the initial levels. It was also found out that there was a statistically significant difference between the two groups when compared in terms of these symptoms (p < 0.0001).
  
  
  CONCLUSIONS
  While the use of dienogest normalizes the general psychological situation and sleep, it was observed that the use of medroxyprogesterone acetate (MPA) worsens the general psychological situation.
authors.affiliation: Department of Obstetrics and Gynecology, Bozok University Faculty of Medicine, Yozgat, Turkey.
authors.forename: Emel Kiyak
authors.initials: EK
authors.lastname: Caglayan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kara
authors.forename: Sema
authors.initials: S
authors.lastname: Etiz
authors.forename: Pinar
authors.initials: P
authors.lastname: Kumru
authors.forename: Nurettin
authors.initials: N
authors.lastname: Aka
authors.forename: Gultekin
authors.initials: G
authors.lastname: Kose
mesh_terms: D000368:Aged; D004338:Drug Combinations; D004958:Estradiol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use*; D008593:Menopause / Q000187:drug effects* / Q000523:psychology; D008875:Middle Aged; D009277:Nandrolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D004338:Drug Combinations; C454300:estradiol valerate-dienogest; D004958:Estradiol; D009277:Nandrolone; D017258:Medroxyprogesterone Acetate