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Symptom experience after discontinuing use of estrogen plus progestin
Women’s Health Research Faculty Publications
  • Judith K. Ockene, University of Massachusetts Medical School
  • David H. Barad, Albert Einstein College of Medicine
  • Barbara B. Cochrane, Fred Hutchinson Cancer Research Center
  • Joseph C. Larson, Fred Hutchinson Cancer Research Center
  • Margery Gass, University of Cincinnati College of Medicine
  • Sylvia Wassertheil-Smoller, Albert Einstein College of Medicine
  • JoAnn E. Manson, Harvard Medical School
  • Vanessa M. Barnabei, Medical College of Wisconsin
  • Dorothy S. Lane, State University of New York
  • Robert G. Brzyski, University of Texas at San Antonio
  • Milagros C. Rosal, University of Massachusetts Medical School
  • Judy Wylie-Rosett, Albert Einstein College of Medicine
  • Jennifer Hays, Baylor Medical College
UMMS Affiliation
Department of Medicine, Division of Preventive and Behavioral Medicine
Publication Date
Document Type
Aged; Anxiety; Cross-Sectional Studies; *Estrogen Replacement Therapy; Estrogens; Estrogens, Conjugated (USP); Female; Humans; Logistic Models; Medroxyprogesterone 17-Acetate; *Menopause; Middle Aged; Pain; Progestins; Randomized Controlled Trials as Topic; *Substance Withdrawal Syndrome; Vasomotor System
CONTEXT: Little is known about women's experiences after stopping menopausal hormone therapy. OBJECTIVE: To describe women's symptoms and management strategies after stopping the intervention in a large estrogen plus progestin trial. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional survey of 8405 women (89.9%; N = 9351) at 40 clinical centers who were still taking study pills (conjugated equine estrogens plus medroxyprogesterone [CEE + MPA] or placebo) when the estrogen plus progestin intervention (Women's Health Initiative) was stopped. Surveys were mailed 8 to 12 months after the stop date. Logistic regression was used to model vasomotor symptoms and pain or stiffness symptoms as functions of former treatment and baseline symptoms, adjusted for appropriate covariates. MAIN OUTCOME MEASURES: Symptoms (vasomotor or pain and stiffness) and management strategies. RESULTS: Respondents' mean (SD) age at trial stop date was 69.1 (6.7) years. They averaged 5.7 years of taking study pills. Moderate or severe vasomotor symptoms after discontinuing study pill use were reported by 21.2% of former CEE + MPA and 4.8% of placebo group respondents overall and by 55.5% and 21.3%, respectively, with these symptoms at baseline (randomization). Compared with respondents in the former placebo group, moderate or severe vasomotor symptoms (adjusted odds ratio [AOR] 5.82; 95% confidence interval [CI], 4.92-6.89) and pain or stiffness symptoms (AOR, 2.16; 95% CI, 1.95-2.40) were more likely in respondents in the former CEE + MPA group. Both vasomotor symptoms (AOR, 5.36; 95% CI, 4.51-6.38) and pain or stiffness symptoms (AOR, 3.21; 95% CI, 2.90-3.56) also were more likely in women with these symptoms at baseline. Women reported a wide range of strategies to manage symptoms. CONCLUSIONS: More than half of the women with vasomotor symptoms at randomization to active CEE + MPA also reported these symptoms after discontinuing use of the study pills. However, these participants did not include women who were unwilling to be randomized or who had stopped taking the study pills earlier. These findings should be considered when advising women to treat menopausal symptoms with hormone therapy for as short duration as possible. Investigation of alternative strategies to manage menopausal symptoms is warranted.
DOI of Published Version
JAMA. 2005 Jul 13;294(2):183-93. Link to article on publisher's site
Related Resources
Link to article in PubMed
PubMed ID
Citation Information
Judith K. Ockene, David H. Barad, Barbara B. Cochrane, Joseph C. Larson, et al.. "Symptom experience after discontinuing use of estrogen plus progestin" Vol. 294 Iss. 2 (2005) ISSN: 1538-3598 (Electronic)
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