Progestogen addition during oestrogen replacement therapy--effects on vasomotor symptoms and mood

Vasomotor symptoms and mood changes were followed in 2 groups of post-menopausal women receiving cyclic replacement therapy with 3 mg/day of percutaneous oestradiol-17 beta alone or in sequential combination (days 11-21) with lynestrenol 5 mg/day. During 6 mth of therapy, daily symptom ratings were performed using a visual analogue scale technique. Serum levels of oestradiol were similar in both groups but sequential oestrogen/progestogen treatment was more efficient in suppressing vasomotor symptoms and serum gonadotropins. However, all negative mood symptoms were also more pronounced in this group. Progestogen addition may enhance the therapeutic effect on hot flushes and sweats but, at least in individual women cause unfavourable effects on mental status, mood and well-being.