Clinical Science (London, England : 1979), 112(10), 517-525, 2007
Medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes: a 1-year randomized double-blind trial following premenopausal ovariectomy
Ewoud ter Avest, Anton F. H. Stalenhoef , Jacqueline de Graaf
Charmaine B Dean , Christine L Hitchcock , J Nielsen, Jerilynn C Prior, Y M Vigna, Lucy A Williams
Author affiliations (5)
Division of General Internal Medicine, Department of Medicine, Radboud University, Nijmegen Medical Centre, 6500 HB Nijmegen, The Netherlands
Oestrogen therapy is the gold standard treatment for hot flushes/night sweats, but it and oestrogen/progestin are not suitable for all women. MPA (medroxyprogesterone acetate) reduces hot flushes, but its effectiveness compared with oestrogen is unknown. In the present study, oral oestrogen [CEE (conjugated equine oestrogen)] and MPA were compared for their effects on hot flushes in a planned analysis of a secondary outcome for a 1-year randomized double-blind parallel group controlled trial in an urban academic medical centre. Participants were healthy menstruating women prior to hysterectomy/ovariectomy for benign disease. A total of 41 women {age, 45 (5) years [value is mean (S.D.)]} were enrolled; 38 women were included in this analysis of daily identical capsules containing CEE (0.6 mg/day) or MPA (10 mg/day). Demographic variables did not differ at baseline. Daily data provided the number of night and day flushes compared by group. The vasomotor symptom day-to-day intensity change was assessed by therapy assignment. Hot flushes/night sweats were well controlled in both groups, one occurred on average every third day and every fourth night. Mean/day daytime occurrences were 0.363 and 0.187 with CEE and MPA respectively, but were not significantly different (P=0.156). Night sweats also did not differ significantly (P=0.766). Therapies were statistically equivalent (within one event/24 h) in the control of vasomotor symptoms. Day-to-day hot flush intensity decreased with MPA and tended to remain stable with CEE (P<0.001). In conclusion, this analysis demonstrates that MPA and CEE are equivalent and effective in the control of the number of hot flushes/night sweats immediately following premenopausal ovariectomy.
Prior JC medroxyprogesterone hot flushes randomized double-blind trial, MPA versus conjugated estrogen hot flush treatment equivalence, progesterone therapy hot flashes surgical menopause ovariectomy, medroxyprogesterone acetate vasomotor symptom control premenopausal ovariectomy, progestin alternative estrogen hot flush night sweat treatment, MPA CEE equivalent hot flush control randomized trial, non-estrogen treatment hot flushes medroxyprogesterone Prior, surgical menopause vasomotor symptom management progesterone, day-to-day hot flush intensity MPA versus estrogen, progestogen monotherapy vasomotor symptoms double-blind parallel group
PMID 17419685 17419685 DOI 10.1042/CS20060228 10.1042/CS20060228
Cite this article
Prior, J. C., Nielsen, J. D., Hitchcock, C. L., Williams, L. A., Vigna, Y. M., & Dean, C. B. (2007). Medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes: a 1-year randomized double-blind trial following premenopausal ovariectomy. Clinical Science (London, England : 1979), 112(10), 517-525. https://doi.org/10.1042/CS20060228
Prior JC, Nielsen JD, Hitchcock CL, Williams LA, Vigna YM, Dean CB. Medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes: a 1-year randomized double-blind trial following premenopausal ovariectomy. Clin Sci (Lond). 2007;112(10):517-525. doi:10.1042/CS20060228
Prior, J. C., et al. "Medroxyprogesterone and conjugated oestrogen are equivalent for hot flushes: a 1-year randomized double-blind trial following premenopausal ovariectomy." Clinical science (London, England : 1979), vol. 112, no. 10, 2007, pp. 517-525.
To determine effectiveness of transdermal progesterone cream for controlling vasomotor symptoms and preventing postmenopausal bone loss. We randomly assigned 102 healthy women within 5 years of menopause to transdermal progesterone cream or placebo. Study subjects and investigators were masked until data analysis was completed. An initial evaluation included complete history, physical examination, bone mineral density determination, and serum studies (TSH, FSH, lipid profile, and chemistry profile). Subjects were instructed to apply a quarter teaspoon of cream (containing 20 mg progesterone or placebo) to the skin daily. Each woman received daily multivitamins and 1200 mg of calcium and were seen every 4 months for review of symptoms. Bone scans and serum chemistries were repeated after 1 year. Thirty of the 43 (69%) in the treatment group and 26 of the 47 (55%) in the placebo group complained initially of vasomotor symptoms. Improvement or resolution of vasomotor symptoms, as determined by review of weekly symptom diaries, was noted in 25 of 30 (83%) treatment subjects and five of 26 (19%) placebo subjects (P < .001). However, the number of women who showed gain in bone mineral density exceeding 1.2% did not differ (alpha = .05, power of 80%). Although we found no protective effect on bone density after 1 year, we did see a significant improvement in vasomotor symptoms in the treated group.