| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH |
From the Medical College of Wisconsin, Milwaukee, Wisconsin; University of California, San Francisco, San Francisco, California; Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia; University of Pittsburgh, Pittsburgh, Pennsylvania; University of California, San Diego, San Diego, California; Stanford University, Palo Alto, California; and Wyeth-Ayerst Research, Philadelphia, Pennsylvania.
Address reprint requests to: Vanessa M. Barnabei, MD, PhD, Medical College of Wisconsin, Department of Obstetrics and Gynecology, 9200 West Wisconsin Avenue, Milwaukee, WI 53226; E-mail: barnabei{at}mcw.edu.
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.
This article has been cited by other articles:
|
|
 |
|
  A. J. Huang, D. Grady, V. L. Jacoby, T. L. Blackwell, D. C. Bauer, and G. F. Sawaya Persistent Hot Flushes in Older Postmenopausal Women Arch Intern Med, April 28, 2008; 168(8): 840 - 846. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Thurston, M. R. Sowers, Y. Chang, B. Sternfeld, E. B. Gold, J. M. Johnston, and K. A. Matthews Adiposity and Reporting of Vasomotor Symptoms among Midlife Women: The Study of Women's Health Across the Nation Am. J. Epidemiol., January 1, 2008; 167(1): 78 - 85. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Collins, G. Rosano, C. Casey, C. Daly, M. Gambacciani, P. Hadji, R. Kaaja, T. Mikkola, S. Palacios, R. Preston, et al. Management of cardiovascular risk in the peri-menopausal woman: a consensus statement of European cardiologists and gynaecologists Eur. Heart J., August 2, 2007; 28(16): 2028 - 2040. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Huang, D. Grady, T. Blackwell, and D. Bauer Hot Flushes, Bone Mineral Density, and Fractures in Older Postmenopausal Women Obstet. Gynecol., April 1, 2007; 109(4): 841 - 847. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Brunner, M. Gass, A. Aragaki, J. Hays, I. Granek, N. Woods, E. Mason, R. Brzyski, J. Ockene, A. Assaf, et al. Effects of Conjugated Equine Estrogen on Health-Related Quality of Life in Postmenopausal Women With Hysterectomy: Results From the Women's Health Initiative Randomized Clinical Trial Arch Intern Med, September 26, 2005; 165(17): 1976 - 1986. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. K. Ockene, D. H. Barad, B. B. Cochrane, J. C. Larson, M. Gass, S. Wassertheil-Smoller, J. E. Manson, V. M. Barnabei, D. S. Lane, R. G. Brzyski, et al. Symptom Experience After Discontinuing Use of Estrogen Plus Progestin JAMA, July 13, 2005; 294(2): 183 - 193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. M. Barnabei, B. B. Cochrane, A. K. Aragaki, I. Nygaard, R. S. Williams, P. G. McGovern, R. L. Young, E. C. Wells, M. J. O'Sullivan, B. Chen, et al. Menopausal Symptoms and Treatment-Related Effects of Estrogen and Progestin in the Women's Health Initiative Obstet. Gynecol., May 1, 2005; 105(5): 1063 - 1073. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. B. Peterson, S. B. Thacker, P. S. Corso, P. A. Marchbanks, and J. P. Koplan Hormone Therapy: Making Decisions in the Face of Uncertainty Arch Intern Med, November 22, 2004; 164(21): 2308 - 2312. [Full Text] [PDF]
|
|
|
|
|
|
N. F. Col, G. Weber, A. Stiggelbout, J. Chuo, R. D'Agostino, and P. Corso Short-term Menopausal Hormone Therapy for Symptom Relief: An Updated Decision Model Arch Intern Med, August 9, 2004; 164(15): 1634 - 1640. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. D. Nelson Commonly Used Types of Postmenopausal Estrogen for Treatment of Hot Flashes: Scientific Review JAMA, April 7, 2004; 291(13): 1610 - 1620. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Z. Ke, G. L. Foley, H. A. Simmons, V. Shen, and D. D. Thompson Long-Term Treatment of Lasofoxifene Preserves Bone Mass and Bone Strength and Does Not Adversely Affect the Uterus in Ovariectomized Rats Endocrinology, April 1, 2004; 145(4): 1996 - 2005. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 OTHER ARTICLES NOTED (24 Jan 03 to 18 Apr 03) Evid. Based Nurs., July 1, 2003; 6(3): e1 - 12. [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hays, J. K. Ockene, R. L. Brunner, J. M. Kotchen, J. E. Manson, R. E. Patterson, A. K. Aragaki, S. A. Shumaker, R. G. Brzyski, A. Z. LaCroix, et al. Effects of Estrogen plus Progestin on Health-Related Quality of Life N. Engl. J. Med., May 8, 2003; 348(19): 1839 - 1854. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Menopausal Symptoms Common in Older Women Journal Watch (General), January 14, 2003; 2003(114): 7 - 7. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
