accrues recently released by the Wo...

accrues recently released by the Women's Health Initiative (WHI) showing an association between combination hormone therapy and cardiovascular and breast cancer risks have quicked revisions in guidelines for the use of hormone therapy. The revised guidelines give an inkling of limiting the use of combination hormone therapy to short-term treatment of menopausal symptoms or for prophylaxis of osteoporosis if other alternatives are not suitable. Previous randomized trials upon the effects of hormones forward quality of life have had conflicting arises and have been notable for a substantial placebo meaning Hays and other investigators from the WHI report upon health-related quality-of-life data in relation to use of combination hormone therapy.

As part of the WHI, quality-of-life overlooks were completed by the 16608 postmenopausal women who were randomly assigned to receive a combination of estrogen and progestin or placebo. Any woman already using hormone add tos before the study underwent a three-month washout period before enrollment If patients reported moderate to stiff menopausal symptoms during the washout period, they were discouraged, further not excluded, from trial participation. Women from minority ethnic clusters constituted 16 percent of the contemplation population. The mean age of the total population was 632 years. Quality-of-life inspects included specific scoring assessment of depression, nap disturbance, sexual function, cognitive function, and menopausal symptoms. Data were available at one-year follow-up in succession almost all study enrollees, and a subgroup of 1511 women was resurvey after three years of trial participation. Discontinuation of the assigned application of mind medication was similar in those randomized to hormones (97 percent) and placebo (66 percent)

Overall, quality-of-life scores were not substantially different at the same year of follow up in any of the life areas measure and estimateed The large number of trial participants allowed small scrutinize score changes to achieve statistical significance in any cases. However, no rating scale changed from more than 2 points not at home of a 100-point scale, thereby demonstrating no clinically significant advantage to use of hormones.

In the subgroup of 1511 women resurvey after three years of application of mind participation, there were again no clinically significant changes associated with hormone use. Age, ethnicity, material substance mass index, and previous use of hormones had no drift on outcomes. If the data analysis was limited to and nothing else the most recently menopausal women (i.e., those younger than 54 years) who also reported moderate-to-severe vasomotor symptoms before the trial, an improvement in rest disturbance was noted, but no other quality-of-life assessment changed with use of combination hormone therapy.

The authors bring to an end that there were no clinically significant quality-of-life advantages apparent after single or three years of hormone use in this inquiry population of postmenopausal women.

Hays J et al. powers of estrogen plus progestin onward health-related quality of life. N Engl J M May 8 2003;348: 1839-54

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group