Abstract
BackgroundFor postmenopausal women, the main reason to start hormone therapy (HT) is to reduce menopausal symptoms and to improve quality of life (QOL). The aim of this study was to analyse the impact of HT on different aspects of symptom experience and QOL during a randomised trial.A total of 1823 postmenopausal women were recruited into the Estonian Postmenopausal Hormone Therapy (EPHT) trial in 1999–2001. Women were randomised to blind HT, open-label HT, placebo or non-treatment arm. After one year in the trial, a questionnaire was mailed and 1359 women (75%) responded, 686 in the HT arms and 673 in the non-HT arms. Mean age at filling in the questionnaire was 59.8 years. The questionnaire included Women's Health Questionnaire (WHQ) to assess menopause specific QOL of middle-aged women together with a 17-item questionnaire on symptoms related to menopause, a question about painful intercourse, and a question about women's self-rated health.ResultsAfter one year in the trial, fewer women in the HT arms reported hot flashes, trouble sleeping, and sweating on the symptom questionnaire. According to WHQ, women in the HT arms had fewer vasomotor symptoms, sleep problems, and problems with sexual behaviour, but more menstrual symptoms; HT had no effect on depression, somatic symptoms, memory, attractiveness, or anxiety. A smaller proportion of women reported painful intercourse in the HT arms. There were no significant differences between the trial arms in women’s self-rated subjective health.ConclusionsThe results from the EPHT trial confirm that HT is not justified for treating symptoms, other than vasomotor symptoms, among postmenopausal women. WHQ proved to be a useful and sensitive tool to assess QOL in this age group of women.
Highlights
For postmenopausal women, the main reason to start hormone therapy (HT) is to reduce menopausal symptoms and to improve quality of life (QOL)
The mean age of respondents in the HT arms was statistically significantly lower than that in the nonHT arms (59.5 versus 60.1 years, SD 4.0), still the median age of respondents was the same in HT and non-HT arms and there was no difference between the trial arms as regards time since menopause
The mean age of all women participating in the HT arms of the trial was a bit lower than those in the non-HT arms
Summary
The main reason to start hormone therapy (HT) is to reduce menopausal symptoms and to improve quality of life (QOL). The aim of the present study, which was part of the Estonian Postmenopausal Hormone Therapy (EPHT) trial, was to determine whether women receiving HT in a randomised trial experienced fewer symptoms and better QOL after one year of use than women receiving a matched placebo or no drug. Women’s QOL at the end of the first trial year was assessed using a mailed questionnaire which included the Women’s Health Questionnaire (WHQ) [4], which has been developed to investigate psychological and somatic symptoms experienced by peri- and postmenopausal women and its psychometric properties have already been well documented [5,6]. Information on self-rated health status, specific symptoms related to menopause and painful intercourse was compared among women in different trial arms. Yrs 50-54 55-59 60+ Age, yrs mean median SD Education, yrs 12 Marital status married or co-habiting single divorced or widowed Duration of menopause, yrs 3 * χ2-test. † t-test.
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