The Effects of Progesterone Selection on Psychological Symptoms in Hormone Replacement Therapy

Abstract

Objectives. The aim of this study is to evaluate the effects of hormone replacement therapy using dienogest and medroxyprogesterone acetate on psychological symptoms in perimenopausal and postmenopausal women. Material and Methods. A total of 73 patients who sought treatment at the menopause units of the authors' gynecology and obstetrics clinics between of November 2003 and October 2004 complaining of vasomotor symptoms were included in the study prospectively. The cases were divided into two groups: Group I (37 patients) was given 2 mg estradiol valerate and 2 mg dienogest, and Group II (36 patients) was given 2 mg estradiol valerate and 10 mg medroxyprogesterone acetate. The groups' results in months 0 and 6 were compared through the evaluation of vasomotor and psychological symptom levels. Results. No significant difference was found between the groups when the initial levels of vasomotor and psychological symptom subtypes were compared (p = 0.16). It was observed that all the psychological symptoms decreased in the 6th month in the group using dienogest in comparison with the initial situation, and that psychological symptoms increased in the group using medroxyprogesterone acetate in the evaluation performed in the 6th month compared with the initial levels. It was also found out that there was a statistically significant difference between the two groups when compared in terms of these symptoms (p < 0.0001). Conclusions. While the use of dienogest normalizes the general psychological situation and sleep, it was observed that the use of medroxyprogesterone acetate (MPA) worsens the general psychological situation (Adv Clin Exp Med 2014, 23, 1, 63-67).

Progesterone, reproduction, and psychiatric illness

“…In term of mood effects, there have been only a few studies directly comparing two different progestins effect on mood with varied results. Caglayan et al (2014) found that MPA was less favorable than dienogest [174], while another group found worse outcomes for norethindrone than MPA, when both were added to estradiol as part of MHT [169]. Dienogest and norethindrone are both forms of progesterone less commonly used in MHT.…”