Menopausal Symptoms after the Discontinuation of Long-Term Hormone Replacement Therapy in Women under 60: A 3-Year Follow-Up

Abstract

Background: Prescriptions for hormone replacement therapy (HRT) declined following the publication of the Women's Health Initiative study. The number of women who experience recurrence of menopausal symptoms after discontinuation of long-term HRT (LT-HRT), the length of time these symptoms last and the preferred alternative treatments remain unknown. Methods: This prospective 3-year follow-up study analyses the prevalence and intensity of menopausal symptoms that occur in young postmenopausal women who discontinued LT-HRT. Symptoms were evaluated using the Menopause Rating Scale. Results: Women (254) who discontinued LT-HRT (mean use: 6.9 ± 2.3 years) were recruited. Mean age at menopause was 48.1 ± 3.4 years. Mean age at discontinuation was 56.8 ± 3.7 years. 23% of the women were lost to follow-up. Of the remaining 196 women, 93% experienced a recurrence of menopausal symptoms within the first year, 25% resumed low-dose HRT, 62% used vaginal estrogens, 54% used phytoestrogens, and 2% used alternative therapies. A decrease in symptom prevalence and intensity was observed during the 3-year follow-up. Conclusions: Symptoms re-appeared in a significant proportion of patients within the first year after discontinuation of LT-HRT. However, after 3 years, the majority of these women were asymptomatic. Patients who discontinue LT-HRT may require a more detailed follow-up immediately after the discontinuation of treatment.

Morphology and Histomorphometry of the Bladder and Urethra in Ovariectomized Rats after Long-Term Use of Tibolone

“…HT appears to treat the irritative symptoms of urinary frequency and urgency, possibly by reversing the urogenital atrophy [15]. Furthermore, studies in women have reported a recurrence of menopausal symptoms after discontinuation of long-term HT [16]. In this study, the urothelial thickness of the bladder and urethra was similar in both groups.…”

Knowledge and Attitude towards Menopause and Hormone Replacement Therapy in Chinese Women

“…Our current study, however, reports 57% (95% CI: 41-77%) of Chinese women used HRT following a prescription. Under such circumstances, Chinese health providers are encouraged to inform patients better regarding adverse events as well as provide a more detailed follow-up immediately after HRT is discontinued [32]. …”

Comparison of steady state development and reduction of menopausal symptoms after oral or transdermal delivery of 17-β-estradiol in young healthy symptomatic menopausal women

“…Although there are long-term effects of E2 balancing menopausal symptoms [33,48], it is our experience that individual dosing is achieved quicker with the transdermal matrix patch [5]. This is of tremendous practical importance: the tendency to discontinue E2 menopausal therapy is rather high, because women fear side effects and are discouraged, if individual dosing is difficult to achieve [49]. As transdermal E2 dosing can be regulated quickly through modulation of the surface area of the patch, women may be transferred later to oral therapy ( Figure 12) once an individual dose has been identified.…”