A Canadian Observational Study of the Optimal Method of Transition From Postmenopausal Hormone Therapy to Raloxifene

Abstract

ObjectiveTo determine the optimal method of transition from postmenopausal hormone therapy (HT) to raloxifene (RLX) therapy in order to minimize hot flashes and night sweats. MethodsPostmenopausal women in Canada who had discontinued HT (estrogen with or without progestogen) in the preceding nine months and who were starting RLX were followed for approximately nine months in this observational study. The method of transition from HT to RLX therapy (method and duration of tapering HT, duration of washout) and the frequency and severity of hot flashes during the transition and RLX treatment periods were recorded. ResultsThere were 373 women who participated in this study. Most women (86.3%) had a washout period between HT and RLX, and 55.2% had tapered their HT in some fashion. After beginning RLX, women who had had a washout duration of more than one week were found to be more likely to have an improvement in the severity of hot flashes (odds ratio [OR]=6.3), and in the frequency of hot flashes (OR=4.6), than women with a shorter washout or no washout period at all. The method of tapering of HT did not seem to affect either the severity or the frequency of hot flashes once on RLX. Women who had undergone a tapering period of more than one week’s duration were more likely (OR=2.6) to experience an improvement in the frequency (but not the severity) of hot flashes on RLX. ConclusionWomen who had a washout period following HT had better amelioration of hot flashes on RLX therapy.