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Menopausal symptoms in older women and the effects of treatment with hormone therapy.

Abstract

OBJECTIVE

In some women, hot flashes and other symptoms attributed to menopause persist for many years after the cessation of menses. The frequency and severity of such symptoms and response to hormone therapy in older women have not been well documented.

METHODS

We used data from the Heart and Estrogen/Progestin Replacement Study, a blinded, clinical trial among 2763 women with documented coronary disease and a uterus who were randomized to receive either conjugated estrogens 0.625 mg plus medroxyprogesterone acetate 2.5 mg in one tablet or placebo. Participants were queried at baseline and annually regarding menopausal symptoms. Breast symptoms were self-reported, and uterine bleeding was recorded on a daily diary.

RESULTS

Symptoms associated with menopause were relatively common among Heart and Estrogen/Progestin Replacement Study participants, whose average age was 67 years and who averaged 18 years since menopause. At baseline, 16% of women reported frequent hot flashes, 26% vaginal dryness, 10% genital irritation, 55% trouble sleeping, and 53% early awakening. Women assigned to hormone therapy reported less frequent hot flashes, vaginal dryness, and trouble sleeping compared with women assigned to placebo, but more frequent vaginal discharge, genital irritation, uterine bleeding, and breast symptoms. The reporting of breast symptoms among women in the hormone group decreased from 40% at 1 year to 13% by the 4th year. Uterine bleeding was reported by 31% and spotting by an additional 33% of women in the hormone group during the 1st year of treatment; by the 4th year, these proportions had fallen to 11% and 20%, respectively.

CONCLUSION

Symptoms typically attributed to menopause are common in elderly women. Postmenopausal hormone therapy reduces hot flashes, trouble sleeping, and vaginal dryness, but at standard doses in elderly women is associated with vaginal discharge, genital irritation, uterine bleeding, and breast symptoms.

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  • Authors+Show Affiliations

    ,

    Medical College of Wisconsin, Milwaukee 53226, USA. barnabei@mcw.edu

    , , , , , ,

    Source

    Obstetrics and gynecology 100:6 2002 Dec pg 1209-18

    MeSH

    Age Factors
    Aged
    Aged, 80 and over
    Cardiovascular Diseases
    Cohort Studies
    Confidence Intervals
    Evaluation Studies as Topic
    Female
    Hormone Replacement Therapy
    Hot Flashes
    Humans
    Medroxyprogesterone Acetate
    Menopause
    Middle Aged
    Patient Satisfaction
    Probability
    Prognosis
    Randomized Controlled Trials as Topic
    Risk Assessment
    Risk Factors
    Severity of Illness Index
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12468165

    Citation

    Barnabei, Vanessa M., et al. "Menopausal Symptoms in Older Women and the Effects of Treatment With Hormone Therapy." Obstetrics and Gynecology, vol. 100, no. 6, 2002, pp. 1209-18.
    Barnabei VM, Grady D, Stovall DW, et al. Menopausal symptoms in older women and the effects of treatment with hormone therapy. Obstet Gynecol. 2002;100(6):1209-18.
    Barnabei, V. M., Grady, D., Stovall, D. W., Cauley, J. A., Lin, F., Stuenkel, C. A., ... Pickar, J. H. (2002). Menopausal symptoms in older women and the effects of treatment with hormone therapy. Obstetrics and Gynecology, 100(6), pp. 1209-18.
    Barnabei VM, et al. Menopausal Symptoms in Older Women and the Effects of Treatment With Hormone Therapy. Obstet Gynecol. 2002;100(6):1209-18. PubMed PMID: 12468165.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Menopausal symptoms in older women and the effects of treatment with hormone therapy. AU - Barnabei,Vanessa M, AU - Grady,Deborah, AU - Stovall,Dale W, AU - Cauley,Jane A, AU - Lin,Feng, AU - Stuenkel,Cynthia A, AU - Stefanick,Marcia L, AU - Pickar,James H, PY - 2002/12/7/pubmed PY - 2003/1/11/medline PY - 2002/12/7/entrez SP - 1209 EP - 18 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 100 IS - 6 N2 - OBJECTIVE: In some women, hot flashes and other symptoms attributed to menopause persist for many years after the cessation of menses. The frequency and severity of such symptoms and response to hormone therapy in older women have not been well documented. METHODS: We used data from the Heart and Estrogen/Progestin Replacement Study, a blinded, clinical trial among 2763 women with documented coronary disease and a uterus who were randomized to receive either conjugated estrogens 0.625 mg plus medroxyprogesterone acetate 2.5 mg in one tablet or placebo. Participants were queried at baseline and annually regarding menopausal symptoms. Breast symptoms were self-reported, and uterine bleeding was recorded on a daily diary. RESULTS: Symptoms associated with menopause were relatively common among Heart and Estrogen/Progestin Replacement Study participants, whose average age was 67 years and who averaged 18 years since menopause. At baseline, 16% of women reported frequent hot flashes, 26% vaginal dryness, 10% genital irritation, 55% trouble sleeping, and 53% early awakening. Women assigned to hormone therapy reported less frequent hot flashes, vaginal dryness, and trouble sleeping compared with women assigned to placebo, but more frequent vaginal discharge, genital irritation, uterine bleeding, and breast symptoms. The reporting of breast symptoms among women in the hormone group decreased from 40% at 1 year to 13% by the 4th year. Uterine bleeding was reported by 31% and spotting by an additional 33% of women in the hormone group during the 1st year of treatment; by the 4th year, these proportions had fallen to 11% and 20%, respectively. CONCLUSION: Symptoms typically attributed to menopause are common in elderly women. Postmenopausal hormone therapy reduces hot flashes, trouble sleeping, and vaginal dryness, but at standard doses in elderly women is associated with vaginal discharge, genital irritation, uterine bleeding, and breast symptoms. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/12468165/Menopausal_symptoms_in_older_women_and_the_effects_of_treatment_with_hormone_therapy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0029784402023694 DB - PRIME DP - Unbound Medicine ER -