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. 2020 Oct;27(10):1126-1136.
doi: 10.1097/GME.0000000000001597.

Effects of pharmacologic and nonpharmacologic interventions on menopause-related quality of life: a pooled analysis of individual participant data from four MsFLASH trials

Susan J Diem  1   2   3 , Andrea Z LaCroix  4 , Susan D Reed  5 , Joseph C Larson  6 , Katherine M Newton  7 , Kristine E Ensrud  1   2   3 , Nancy F Woods  8 , Katherine A Guthrie  6
Affiliations

Effects of pharmacologic and nonpharmacologic interventions on menopause-related quality of life: a pooled analysis of individual participant data from four MsFLASH trials

Susan J Diem et al. Menopause. 2020 Oct.

Abstract

Objective: The Menopause Strategies: Finding Lasting Answers for Symptoms and Health network conducted three randomized clinical trials (RCTs) testing six interventions treating vasomotor symptoms (VMS), and also collected menopause-related quality of life (QOL) measures. A fourth RCT assessed an intervention for insomnia symptoms among women with VMS. We describe these seven interventions' effects on menopause-related QOL relative to control in women with VMS.

Methods: We pooled individual-level data from 1,005 peri- and postmenopausal women with 14 or more VMS/week across the four RCTs. Interventions included escitalopram 10 to 20 mg/d; yoga/aerobic exercise; 1.8 g/d omega-3-fatty acids; oral 17-beta-estradiol 0.5 mg/d; venlafaxine XR 75 mg/d; and cognitive behavioral therapy for insomnia (CBT-I). Outcomes measures were the Menopause-specific Quality of Life scale and its subscales.

Results: Significant improvements in total Menopause-specific Quality of Life from baseline were observed with estradiol, escitalopram, CBT-I, and yoga, with mean decreases of 0.3 to 0.5 points relative to control. The largest improvement in the vasomotor subscale was observed with estradiol (-1.2 points), with more modest but significant effects seen with escitalopram, yoga, and CBT-I. Significant improvements in the psychosocial subscale were observed for escitalopram, venlafaxine, and CBT-I. For the physical subscale, the greatest improvement was observed for CBT-I and exercise, whereas for the sexual subscale, the greatest improvement was observed for CBT-I, with yoga and estradiol demonstrating smaller effects.

Conclusions: These results suggest that for menopause-related QOL, women have a variety of treatment strategies to choose from and can select an approach based on most bothersome symptoms and individual preferences.

Trial registration: ClinicalTrials.gov NCT00894543 NCT01178892 NCT01418209 NCT01936441.

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Figures

Figure 1.
Figure 1.
Effect of each intervention relative to control on changes from baseline in MENQOL Total score
Figure 2.
Figure 2.
Effect of each intervention relative to control on changes from baseline in MENQOL Vasomotor domain score
Figure 3.
Figure 3.
Effect of each intervention relative to control on changes from baseline in MENQOL Psychosocial domain score
Figure 4.
Figure 4.
Effect of each intervention relative to control on changes from baseline in MENQOL Physical domain score
Figure 5.
Figure 5.
Effect of each intervention relative to control on changes from baseline in MENQOL Sexual domain score
See this image and copyright information in PMC

References

    1. Williams RE, Levine KB, Kalilani L, Lewis J, Clark RV. Menopause-specific questionnaire assessment in US population-based study shows negative impact on health-related quality of life. Maturitas. 2009;62(2):153–159. doi:10.1016/j.maturitas.2008.12.006 - DOI - PubMed
    1. Avis NE, Colvin A, Bromberger JT, et al. Change in health-related quality of life over the menopausal transition in a multiethnic cohort of middle-aged women: Study of Women’s Health Across the Nation. Menopause N Y N. 2009;16(5):860–869. doi:10.1097/gme.0b013e3181a3cdaf - DOI - PMC - PubMed
    1. Utian WH, Woods NF. Impact of hormone therapy on quality of life after menopause. Menopause N Y N. 2013;20(10):1098–1105. doi:10.1097/GME.0b013e318298debe - DOI - PubMed
    1. Barnabei VM, Cochrane BB, Aragaki AK, et al. Menopausal symptoms and treatment-related effects of estrogen and progestin in the Women’s Health Initiative. Obstet Gynecol. 2005;105(5 Pt 1):1063–1073. doi:10.1097/01.AOG.0000158120.47542.18 - DOI - PubMed
    1. Cohen LS, Joffe H, Guthrie KA, et al. Efficacy of omega-3 for vasomotor symptoms treatment: a randomized controlled trial. Menopause N Y N. 2014;21(4):347–354. doi:10.1097/GME.0b013e31829e40b8 - DOI - PMC - PubMed

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