Effect of abrupt discontinuation versus gradual dose reduction of postmenopausal hormone therapy on hot flushes

Cunha, E P; Azevedo, Lúcia Helena de; Pompei, Luciano de Melo; Strufaldi, Rodolfo; Steiner, Marcelo Luis; Ferreira, José Arnaldo S.; Peixoto, Sérgio Viana; Fernandes, César Eduardo

doi:10.3109/13697130903568534

Cited by 5 publications

(3 citation statements)

References 17 publications

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“…Given that case 1 discontinued HR 3 months prior to PRP treatment, the potential influence of HR requires further consideration. Several RCTs and comparative cohort studies on the effect of HR in menopausal women have shown that menopausal symptoms reoccur after 3 months of discontinuing HR 40 . In light of this data, HR administration for patient 1 may be safely viewed as an independent characteristic unrelated to the effectiveness of PRP treatment 41 .…”

Section: Discussionmentioning

confidence: 99%

A Case Series on Natural Conceptions Resulting in Ongoing Pregnancies in Menopausal and Prematurely Menopausal Women Following Platelet-Rich Plasma Treatment

Pantos¹,

Simopoulou

Pantou³

et al. 2019

Cell Transplant

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Since the introduction of autologous platelet-rich plasma (PRP) in medical practice, various studies have documented that implementing PRP can enhance healing and the anti-aging process, employing angiogenesis regeneration due to the multiple growth factors and cytokines involved. Numerous reports have shown promising results with the use of PRP in ovarian treatment, regarding ovarian regeneration and reactivation of folliculogenesis. This case series reports on two women with premature ovarian failure (POF) aged 40 and 27 years, respectively, and one menopausal woman aged 46 years. All patients presented with lack of menstrual cycle for over a year. The women reported previous failed in vitro fertilization (IVF) attempts, and, after rejecting the option of oocyte donation, they opted for the approach of autologous ovarian PRP treatment. Following PRP treatment, the three patients were invited to conceive naturally. The primary outcome was the restoration of menstruation following autologous ovarian PRP treatment, as well as an improvement in hormonal profile, a decrease in follicle-stimulating hormone (FSH) levels, and a concurrent increase in anti-Müllerian hormone (AMH) levels. Further to that, our patients achieved pregnancy through natural conception within 2–6 months following PRP treatment, resulting in currently ongoing complication-free clinical pregnancies – a first report in the literature for menopausal and POF patients. Implementation of PRP should be further investigated through randomized controlled trials (RCTs), as it may hold the key to successful treatment for a certain cohort of patients exploring reproductive treatment options following menopause.

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Section: Discussionmentioning

confidence: 99%

A Case Series on Natural Conceptions Resulting in Ongoing Pregnancies in Menopausal and Prematurely Menopausal Women Following Platelet-Rich Plasma Treatment

Pantos¹,

Simopoulou

Pantou³

et al. 2019

Cell Transplant

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“…Half of the women in each group resumed HT within a year. 27 Overall, little data are available on tapered approaches to HT discontinuation. Longer and gradual tapers might successfully ease women off HT.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Successful Discontinuation of Hormone Therapy

Newton

Reed

Nekhyludov

et al. 2014

Journal of Women's Health

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Background: Careful management of symptoms, particularly sleep and mood disturbances, may assist women in discontinuing hormone therapy (HT). We sought to describe characteristics associated with successful HT cessation in women who attempted to discontinue estrogen pills/patches with or without progestin. Results: Among 802 women who attempted HT discontinuation, the mean age was 50 years, 93% were postmenopausal, 90% were white, 30% had had a hysterectomy, and 75% experienced hot flashes after discontinuation. Those who did not succeed had greater trouble sleeping (74% vs. 57%) and mood disturbances (51% vs. 34%) than those who succeeded. In multivariable analyses, factors associated with successful discontinuation included doctor advice (odds ratio [OR] 2.62, 95% confidence interval [CI] 1.68-4.08), lack of symptom improvement (OR 4.21, vaginal bleeding (OR 5.96,, and learning to cope with symptoms (OR 3.36, CI 2.21-5.11). Factors associated with unsuccessful HT discontinuation included trouble sleeping (OR 0.40, CI 0.26-0.61) and mood swings or depression (OR 0.63,. Conclusions: Doctor advice is strongly associated with successful HT discontinuation. Symptom management, particularly sleep and mood disturbances, may help women discontinue HT.

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“…Results from the few randomized clinical trials to date comparing abrupt discontinuation (Bcold turkey[) with tapering provide little evidence to prefer one method to another. 25 Abrupt discontinuation and tapering have been compared in observational studies, but women who elect to taper differ from those who choose abrupt discontinuation, 21,26 complicating a causal interpretation. 8,24 Another study found no differences 9 to 12 months after discontinuation, although the abruptdiscontinuation group had higher rates of VMS at 3 months but lower rates of VMS at 6 months.…”

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confidence: 99%

What should women expect after stopping hormone therapy?

Crawford¹

2015

Menopause

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Effect of abrupt discontinuation versus gradual dose reduction of postmenopausal hormone therapy on hot flushes

Abstract: Discontinuation of HT by reducing the daily dose of estrogen for a period of 2 or 4 months did not differ in its effect from that of abrupt cessation with regard to vasomotor symptoms.

Cited by 5 publications

References 17 publications

A Case Series on Natural Conceptions Resulting in Ongoing Pregnancies in Menopausal and Prematurely Menopausal Women Following Platelet-Rich Plasma Treatment

A Case Series on Natural Conceptions Resulting in Ongoing Pregnancies in Menopausal and Prematurely Menopausal Women Following Platelet-Rich Plasma Treatment

Factors Associated with Successful Discontinuation of Hormone Therapy

What should women expect after stopping hormone therapy?

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