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https://hdl.handle.net/2440/53531
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Type: | Journal article |
Title: | Health related quality of life after combined hormone replacement therapy: randomised controlled trial |
Author: | Welton, A. Vickers, M. Kim, J. Ford, D. Lawton, B. MacLennan, A. Meredith, S. Martin, J. Meade, T. |
Citation: | BMJ: British Medical Journal, 2008; 337(7669):550-553 |
Publisher: | British Med Journal Publ Group |
Issue Date: | 2008 |
ISSN: | 0959-535X 0959-8146 |
Statement of Responsibility: | Amanda J Welton, Madge R Vickers, Joseph Kim, Deborah Ford, Beverley A Lawton, Alastair H MacLennan, Sarah K Meredith, Jeannett Martin and Tom W Meade for the WISDOM team |
Abstract: | Objective: To assess the effect of combined hormone replacement therapy (HRT) on health related quality of life. Design: Randomised placebo controlled double blind trial. Setting: General practices in United Kingdom (384), Australia (94), and New Zealand (24). Participants Postmenopausal women aged 50-69 at randomisation; 3721 women with a uterus were randomised to combined oestrogen and progestogen (n=1862) or placebo (n=1859). Data on health related quality of life at one year were available from 1043 and 1087women, respectively. Interventions: Conjugated equine oestrogen 0.625 mg plus medroxyprogesterone acetate 2.5/5.0 mg or matched placebo orally daily for one year. Main outcome measures: Health related quality of life and psychological wellbeing as measured by the women’s health questionnaire. Changes in emotional and physical menopausal symptoms as measured by a symptoms questionnaire and depression by the Centre for Epidemiologic Studies depression scale (CES-D). Overall health related quality of life and overall quality of life as measured by the European quality of life instrument (EuroQol) and visual analogue scale, respectively. Results: After one year small but significant improvements were observed in three of nine components of the women’s health questionnaire for those taking combined HRT compared with those taking placebo: vasomotor symptoms (P<0.001), sexual functioning (P<0.001), and sleep problems (P<0.001). Significantly fewer women in the combined HRT group reported hot flushes (P<0.001), night sweats (P<0.001), aching joints and muscles (P=0.001), insomnia (P<0.001), and vaginal dryness (P<0.001) than in the placebo group, but greater proportions reported breast tenderness (P<0.001) or vaginal discharge (P<0.001). Hot flushes were experienced in the combined HRT and placebo groups by 30% and 29% at trial entry and 9% and 25% at one year, respectively. No significant differences in other menopausal symptoms, depression, or overall quality of life were observed at one year. Conclusions: Combined HRT started many years after the menopause can improve health related quality of life. |
Keywords: | WISDOM team Humans Estrogens Progestins Prognosis Drug Therapy, Combination Hormone Replacement Therapy Double-Blind Method Health Status Postmenopause Quality of Life Aged Middle Aged Women's Health Female Surveys and Questionnaires |
DOI: | 10.1136/bmj.a1190 |
Published version: | http://dx.doi.org/10.1136/bmj.a1190 |
Appears in Collections: | Aurora harvest Obstetrics and Gynaecology publications |
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