Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes

MacLennan, Alastair H.; Broadbent, J. L.; Lester, Sue; Moore, Vivienne

doi:10.1002/14651858.cd002978.pub2

Cited by 357 publications

(388 citation statements)

References 87 publications

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“…In the subgroup of patients with moderate to severe vasomotor symptoms at baseline, the hormone treatment effect size was higher and reached statistical significance, supporting the notion that the absolute reduction in hot flashes is positively correlated with their frequency (27). We did not find an additional improvement with hormone therapy in the psychological, subjective-somatic, and organic-somatic factors scores, even though all decreased significantly over time.…”

Section: Discussionsupporting

confidence: 63%

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Efficacy of estrogen plus progestin on menopausal symptoms in women with systemic lupus erythematosus: A randomized, double‐blind, controlled trial

Cravioto¹,

Durand-Carbajal²,

Jiménez-Santana³

et al. 2011

Arthritis Care & Research

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Objective. To define the effects of continuous sequential estrogen plus progestin therapy on menopausal symptoms in women with systemic lupus erythematosus (SLE).Methods. We performed a randomized, double-blind, 24-month clinical trial involving 106 women with SLE who were in the menopausal transition or early or late postmenopause. Patients received continuous sequential estrogen plus progestin (n ‫؍‬ 52) or placebo (n ‫؍‬ 54). Menopausal symptoms were assessed using the Greene Climacteric Scale at 0, 1, 2, 3, 6, 9, 12, 15, 18, 21, and 24 months. A new factor analysis of the scale reduced 21 items to 5 factors. The primary outcome was improvement of menopausal symptoms throughout the followup period. Results were analyzed by the intent-to-treat principle. Results. At baseline, demographic and disease characteristics were similar in both groups. Fifteen of 21 menopausal symptoms had a prevalence of >50%, with a similar distribution between groups. Vasomotor factor scores decreased over time in both groups (P ‫؍‬ 0.002), but in the estrogen plus progestin group the reduction was more pronounced than in the placebo group (1.5-2.0 versus 0.35-0.8 points on a scale of 0 -6; P ‫؍‬ 0.03). Maximum effects were observed among the most symptomatic women. Psychological, subjective-somatic, and organic-somatic factors scores also improved along time (P < 0.001), but the treatment and placebo arms improved to a similar degree. Thromboses occurred in 3 patients receiving estrogen plus progestin and in 1 patient receiving placebo. Conclusion. Menopausal symptoms are highly prevalent in peri-and postmenopausal lupus patients. Estrogen plus progestin improved vasomotor symptoms at a clinically significant level, but not other menopausal symptoms. Given the thrombotic risks of menopausal hormone therapy, this should be used only in women with significant vasomotor symptoms.

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Section: Discussionsupporting

confidence: 63%

“…Lastly, the duration of our study was longer than most clinical trials of treatments for hot flashes, which have typically been small and brief. Only 3 (35-37) of 24 studies included in the meta-analysis published by MacLennan et al (27) lasted 24 months.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of estrogen plus progestin on menopausal symptoms in women with systemic lupus erythematosus: A randomized, double‐blind, controlled trial

Cravioto¹,

Durand-Carbajal²,

Jiménez-Santana³

et al. 2011

Arthritis Care & Research

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“…They can achieve a high level of external validity and provide the most suitable vehicle for economic evaluation and clinical decisionmaking [9,34]. Substantial placebo effects have been measured in trials on menopausal symptoms [35] but placebo controls may be inappropriate even with single modality Chinese medicine treatment ] [36] and impossible with the sort of multi-modal approach used here (and in usual practice) [37].…”

Section: Discussionmentioning

confidence: 99%

Chinese medicine treatment for menopausal symptoms in the UK health service: Is a clinical trial warranted?

et al. 2015

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Abstract:Objectives: The aims of this pilot study were to evaluate treatment effects, ascertain safety and formulate best practice Chinese medicine protocols relevant for London women suffering from menopausal symptoms. Study Design:This clinical pilot study employed a case series design within a wider action-based research project. 117 perimenopausal women between 45-55 years of age recruited from the general population were treated for menopausal symptoms by six experienced practitioners of Chinese medicine at the Polyclinic of the University of Westminster. Practitioners were instructed to treat as near to their usual practice style as possible. This involved using Chinese herbal medicine and/or acupuncture along with dietary and lifestyle advice. A maximum of twelve treatments over six months was allowed per patient. Outcome Measures:The Menopause Specific Quality of Life Questionnaire (MenQoL), the Greene Climacteric Scale, and flushing diaries were used to evaluate treatment outcomes. Liver and kidney function tests were carried out at intake and after one, six and twelve treatments to evaluate the safety particularly in relation to the use of herbal medicines.

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“…In addition, there is a direct effect on vaginal and vulvar atrophies. Treatment other than HT tends to be less effective or completely ineffective 26,27 .…”

Section: Resultsmentioning

confidence: 99%

Self-perception of sexual life and associated factors: a population study conducted in women aged 50 or more years

Valadares¹,

Machado²,

Osis³

et al. 2013

Rev. Bras. Ginecol. Obstet.

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PURPOSE: To evaluate the prevalence of women aged 50 years or more who are sexually active and their self-perception with respect to their sexual lives. Associated factors were also assessed. METHODS: A cross-sectional, populationbased, self-reported household survey involving 622 Brazilian women aged 50 years or more. Sociodemographic, clinical, and behavioral factors were evaluated. The sexual life self-perception was classified as very good, good, fair, poor, or very poor. Data were analyzed using the χ 2 test, Fisher's exact test, and Poisson multiple regression analysis. Prevalence ratios and their 95% confidence intervals were also calculated. RESULTS: Of the women in this sample, 228 (36.7%) reported having a sexual life and, of these, 53.5% classified it as very good or good, while 46.5% considered it fair, poor, or very poor. The bivariate analysis indicated that being postmenopausal (p=0.025) and using natural remedies to treat the menopause (p=0.035) were factors associated with the woman classifying their sexual lives as fair, poor, or very poor. Multiple regression analysis showed that more women who had used or were currently using natural remedies for the menopause scored their sexual lives as fair, poor, or very poor. CONCLUSIONS: More than half the women aged 50 years or more in this study were not sexually active. A poorer sexual life self-perception was associated with the use of natural remedies to treat menopausal symptoms. This may indicate a need to improve the way in which these women are evaluated and treated. Women's assessment of their own sexual lives may prove a useful tool in clinical practice. ResumoOBJETIVO: Avaliar a prevalência de vida sexual em mulheres de 50 anos de idade ou mais, assim como avaliar sua autopercepção em relação à vida sexual e os fatores associados. MÉTODOS: Estudo transversal de base-populacional, por meio de autorrelato em pesquisa domiciliar, envolvendo 622 mulheres brasileiras de 50 anos de idade ou mais. Fatores sociodemográficos, clínicos e comportamentais foram avaliados. A autopercepção da vida sexual foi classificada como muito boa, boa, regular, ruim ou muito ruim. Os dados foram analisados usando-se o teste do χ 2 , o teste exato de Fisher e a análise de regressão múltipla de Poisson. As razões de prevalência e seus intervalos de confiança de 95% foram calculados. RESULTADOS: Das mulheres nesta amostra, 228 (36,7%) relataram ter vida sexual e, destas, 53,5% classificaram-na como muito boa ou boa, enquanto 46,5% consideraram-na regular, ruim ou muito ruim. A análise bivariada indicou que estar na pós-menopausa (p=0,025) e usar remédios naturais para tratamento da menopausa (p=0,035) foram os fatores associados com a classificação da vida sexual pelas mulheres como regular, ruim ou muito ruim. A análise de regressão múltipla mostrou que mulheres que tinham usado ou usavam atualmente remédios naturais para o tratamento da menopausa classificaram sua vida sexual como regular, ruim ou muito ruim. CONCLUSÕES: Mais da metade das mulheres de 50 ano...

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Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes

Abstract: Oral oestrogen and combined oestrogen/progestogen therapy versus placebo for hot flushes.

Cited by 357 publications

References 87 publications

Efficacy of estrogen plus progestin on menopausal symptoms in women with systemic lupus erythematosus: A randomized, double‐blind, controlled trial

Efficacy of estrogen plus progestin on menopausal symptoms in women with systemic lupus erythematosus: A randomized, double‐blind, controlled trial

Chinese medicine treatment for menopausal symptoms in the UK health service: Is a clinical trial warranted?

Self-perception of sexual life and associated factors: a population study conducted in women aged 50 or more years

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