Hormone replacement therapy (HRT) can improve the health-related quality of life of older women, according to a new study that says HRT guidelines should be reviewed in light of this evidence.
Findings from Professor Alastair MacLennan and colleagues on health-related quality of life from the WISDOM trial have been published on the British Medical Journal’s website.
The WISDOM trial began in 1999 and aimed to evaluate the long-term benefits and risks of HRT in postmenopausal women over 10 years.
All women were monitored for an average of 12 months, and in addition to the main clinical outcomes of cardiovascular disease, fractures and breast cancer, a detailed assessment of the impact of HRT on quality of life was recorded.
Quality of life was measured using a modified version of the women's health questionnaire designed to assess physical and emotional components of health such as depressed mood, memory and concentration, sleep problems and sexual functioning, and a symptoms questionnaire.
After one year, the researchers found significant improvements in sexual functioning, sleep problems and vasomotor symptoms (hot flushes and sweats) in the combined HRT group compared to the placebo group.
Significantly fewer women in the HRT group reported hot flushes, night sweats, aching joints and muscles, insomnia, and vaginal dryness than in the placebo group, but more reported breast tenderness and vaginal discharge.
Other menopausal symptoms, depression, and overall quality of life were not significantly different in the two groups.
These findings may have important benefits for many symptomatic women, claim the authors, but they caution that the health-related quality of life benefits must be weighed against the risk of increased cardiac events, venous thromboembolism and breast cancer.