Menopausal hormone therapy in postmenopausal women: the quality of life today and in the long term

Aim: to evaluate an impact of menopausal hormone therapy (MHT) on late postmenopausal multimorbid women’s quality of life (QoL).Materials and Methods. 132 late postmenopausal women were enrolled to the study and were divided into two groups: group 1 consisted of 66 subjects with moderate multimorbidity and Charlson Comorbidity Index (CCI) < 3; group 2 (66 patients) had high multimorbidity (CCI ≥ 3). Women receiving or not MHT were subdivided in both groups. SF-36 questionnaire was used to assess QoL, Hospital Anxiety and Depression scale (HADS) – for evaluating emotional status, MMSE test (Mini-Mental State Examination) – for cognition evaluation. Modified Menopausal Index (MMI) was calculated as well.Results. Women with a low level of comorbidity who had previously received MHT have a significantly higher QoL. The median age for subjects was 69 [65; 71] years, median CCI score was 3.5 [2.5; 5.0]. In addition, in group 2 there were found significantly lower physical functioning (p < 0.001), role-physical functioning (p = 0.028), physical health (p = 0.002) domains, as well as more severe persistent menopausal symptoms (p = 0.011) and depression (p = 0.043). History of MHT in group 1 was associated with higher levels of physical functioning (p = 0.033) and role-physical functioning (p = 0.023), whereas in group 2 MHT was associated with better cognition (p = 0.028) and lower depression symptoms compared with those lacking history of MHT.Conclusion. Multimorbidity in late postmenopausal women was associated with impaired QoL physical domains. MHT allows to effectively improve QoL in women with moderate multimorbidity and to protect cognitive state to higher level as well as reduce depression symptoms in women with severe multimorbidity.

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MENOPAUSAL HORMONOTHERAPY IN ONCOGYNECOLOGIC PATIENTS

Problems in oncology ◽

10.37469/0507-3758-2017-63-6-843-854 ◽

2017 ◽

Vol 63 (6) ◽

pp. 843-854

Author(s):

Olga Novikova ◽

Yelena Ulrikh ◽

V. Nosov ◽

A. Charkhifalakyan

Keyword(s):

Quality Of Life ◽

Cervical Cancer ◽

Endometrial Cancer ◽

Hormone Replacement Therapy ◽

Hormone Therapy ◽

Replacement Therapy ◽

Hormone Replacement ◽

Menopausal Hormone Therapy ◽

Oncological Safety

There is presented the review of domestic and foreign references on the conserved oncological safety of the use of menopausal hormone therapy after treatment for endometrial cancer, cervical cancer, borderline and malignant ovarian tumors, various variants of sarcomas of the uterus, vulva and vaginal cancer. To the opinion of the authors the refusal to prescribe menopausal hormone therapy to patients with oncogynecologic diseases in the anamnesis is usually not justified, the category of patients, to whom hormone replacement therapy is contraindicated, is well described and mentioned in the text. In other cases sex hormones can be used to treat menopausal symptoms and improve the quality of life of patients.

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Quality-of-Life and Depressive Symptoms in Postmenopausal Women After Receiving Hormone Therapy

JAMA ◽

10.1001/jama.287.5.591 ◽

2002 ◽

Vol 287 (5) ◽

pp. 591 ◽

Cited By ~ 186

Author(s):

Mark A. Hlatky ◽

Derek Boothroyd ◽

Eric Vittinghoff ◽

Penny Sharp ◽

Mary A. Whooley ◽

...

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

Hormone Therapy ◽

Postmenopausal Women

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Abstract 2450: A Randomized Controlled Trial of Low Dose Hormone Therapy on Myocardial Ischemia in Postmenopausal Women with No Obstructive Coronary Artery Disease:Results from the NHLBI-sponsored WISE

Circulation ◽

10.1161/circ.116.suppl_16.ii_539 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

C. Bairey Merz ◽

Marian Olson ◽

Candace McClure ◽

James Symons ◽

George Sopko ◽

...

Keyword(s):

Quality Of Life ◽

Chest Pain ◽

Coronary Artery ◽

Endothelial Dysfunction ◽

Myocardial Ischemia ◽

Hormone Therapy ◽

Postmenopausal Women ◽

Brachial Artery ◽

Low Dose

Background: Compared with men, women have more evidence of myocardial ischemia in the setting of no obstructive coronary artery disease (CAD). While low endogenous estrogen levels are associated with endothelial dysfunction, the role of low dose hormone therapy has not been fully evaluated in women suffering from myocardial ischemia and no obstructive CAD. Objective: This WISE ancillary trial evaluated the effect of low dose hormone therapy in postmenopausal women with myocardial ischemia and no obstructive CAD on: endothelial dysfunction, assessed by brachial artery reactivity, physical functional disability assessed by exercise testing, and quality of life assessed by cardiac symptoms and psychological questionnaires. Methods: Using a multicenter, randomized, placebo-controlled design, seventy-four participants with normal/minimally diseased epicardial coronary arteries (<50% luminal diameter stenosis) who fulfilled the inclusion criteria were planned to be randomized to receive either 1 mg norethindrone/10 mcg ethinyl estradiol (1/10 NA/EE) or placebo for twelve weeks. Baseline and exit brachial artery reactivity (BART), exercise stress testing, WISE psychosocial questionnaires, SF-36, blood lipids and hormone levels were evaluated. Results: Recruitment was closed prematurely due to failure to recruit in the year following publication of the Women’s Health Initiative hormone trial results. Of the 37 women randomized, 35 completed the study. While there was no difference in the frequency of chest pain between groups at the baseline visit, at study exit there was less frequent chest pain in the 1/10 NA/EE group compared to the placebo group (p=0.02). Women taking 1/10 NA/EE also showed a trend to improved BART and exercise tolerance, and had significantly fewer hot flashes/night sweats (p=0.003), less avoidance of intimacy (p=0.05), and borderline differences in sexual desire and vaginal dryness (p=0.06). Conclusion: Among postmenopausal women with myocardial ischemia and no obstructive CAD, hormone therapy with 1/10 NA/EE is associated with reduced chest pain symptoms, menopausal symptoms and improved quality of life with trends for improved endothelial function and exercise performance.

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