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Title: HRT Can Improve Quality of Life in Older, Postmenopausal Women
URL: http://www.pslgroup.com/dg/229A46.htm
Doctor's Guide
August 22, 2008

LONDON -- August 22, 2008 -- Hormone replacement therapy (HRT) can improve the health-related quality of life of older women, and HRT guidelines should be reviewed in light of this evidence, according to a study published online at BMJ (British Medical Journal).

Alastair MacLennan, Department of Obstetrics & Gynaecology, University of Adelaide, Adelaide, Australia, and colleagues present the findings on health-related quality of life from the Women's International Study of Long Duration Oestrogen After Menopause (WISDOM) trial.

The trial, which began in 1999, aimed to evaluate the long-term benefits and risks of HRT in postmenopausal women over 10 years. Researchers randomised 5,692 healthy women aged 50 years from general practices in the UK, Australia, and New Zealand to receive either combined HRT or placebo.

The WISDOM trial was halted early when another trial, the Women's Health Initiative (WHI), which also initiated HRT on average 13 years after menopause, found that elderly women taking HRT had more heart attacks than non-HRT users. This was not seen when HRT was initiated near menopause.

All women were monitored for an average of 12 months, and in addition to the main clinical outcomes of cardiovascular disease, fractures, and breast cancer, a detailed assessment of the impact of HRT on quality of life was recorded.

Quality of life was measured using a modified version of the women's health questionnaire -- designed to assess physical and emotional components of health such as depressed mood, memory and concentration, sleep problems, and sexual functioning -- and a symptoms questionnaire.

After 1 year, the researchers found significant improvements in sexual functioning, sleep problems, and vasomotor symptoms in the combined HRT group compared with the placebo group.

Significantly fewer women in the HRT group reported hot flushes (9% vs 25%), night sweats (14% vs 23%), aching joints and muscles (57% vs 63%), insomnia (35% vs 41%), and vaginal dryness (14% vs 19%) than in the placebo group. However, more women reported breast tenderness (16% vs 7%) and vaginal discharge (14% vs 5%).

Other menopausal symptoms, depression, and overall quality of life were not significantly different between both groups.

These results are consistent with the findings of the Women's Health Initiative and support the conclusion that after 1 year, women who started taking combined HRT many years after the menopause, experienced reduced hot flushes and night sweats, improved sleep, and less bodily pain, said the authors.


SOURCE: BMJ

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