Oral oestrogen replacement therapy versus placebo for hot flushes

Area of Science:

• Reproductive Medicine
• Menopause Management
• Clinical Pharmacology

Background:

• Vasomotor symptoms like hot flushes and night sweats are prevalent during menopause.
• Hormone replacement therapy (HRT) is a common treatment for these menopausal symptoms.

Purpose of the Study:

• To evaluate the efficacy of oral HRT versus placebo in managing menopausal vasomotor symptoms.
• To assess the risk of early-onset side-effects associated with oral HRT.

Main Methods:

• Systematic review and meta-analysis of double-blind, randomized, placebo-controlled trials (RCTs) of oral HRT.
• Included trials had a minimum duration of three months.
• Data synthesis included symptom frequency (WMD) and severity (OR), alongside withdrawal rates for efficacy and adverse events.

Main Results:

• Oral HRT significantly reduced hot flush frequency by 77% and severity compared to placebo.
• Withdrawals due to lack of efficacy were higher in the placebo group.
• Withdrawals for adverse events were not significantly increased with HRT, with common events including breast tenderness and joint pain.

Conclusions:

• Oral HRT is a highly effective treatment for menopausal hot flushes and night sweats.
• Rigorous assessment of symptom-reducing therapies requires blinded trials against placebo or validated treatments.
• HRT demonstrated a favorable safety profile regarding withdrawals for side-effects in fixed-dose trials.