ABC School of Medicine, Santo André, Brazil.
Climacteric. 2010 Aug;13(4):362-7. doi: 10.3109/13697130903568534.
To compare the effects of the abrupt discontinuation of postmenopausal hormone therapy (HT) and reduction of the daily dosage of the hormone on climacteric symptoms.
The study included Brazilian postmenopausal women who were using estrogen-progestogen hormone therapy in full doses previously prescribed for vasomotor symptoms. The patients were randomized to receive one of three treatments: placebo for 6 months; estradiol (E2) 1 mg/day + norethisterone acetate (NETA) 0.5 mg/day for 2 months, followed by placebo for 4 months; or E2 1 mg/day + NETA 0.5 mg/day for 4 months, followed by placebo for 2 months. The climacteric symptoms were assessed by the Blatt-Kupperman Menopausal Index at baseline and at 2, 4 and 6 months. Statistical evaluation was performed using the chi(2) or Fisher's test for categorical data, the Kruskal-Wallis test for numerical data, and ANOVA for time and group relationship with the Blatt-Kupperman Menopausal Index.
We randomized 60 women (20 in each group), and 54 completed the study. It was observed that both the full Blatt-Kupperman Menopausal Index and the hot flush score did not change significantly in the HT group during low-dose therapy compared with baseline; however, the evaluation performed at 2 months after low-dose-HT cessation showed that the full Blatt-Kupperman Menopausal Index and the hot flush score were similar to those of the group who stopped HT abruptly and significantly higher than at baseline (hot flush scores: p < 0.001 for all three groups at months 2, 4 and 6, respectively, vs. baseline).
Discontinuation of HT by reducing the daily dose of estrogen for a period of 2 or 4 months did not differ in its effect from that of abrupt cessation with regard to vasomotor symptoms.
比较绝经后激素治疗（HT）突然停药与减少激素日剂量对更年期症状的影响。
该研究纳入了巴西绝经后妇女，她们此前曾使用全剂量雌激素-孕激素激素治疗来缓解血管舒缩症状。患者被随机分为以下三种治疗组之一：6 个月安慰剂组；雌二醇（E2）1mg/天+醋酸炔诺酮（NETA）0.5mg/天，持续 2 个月，然后是 4 个月安慰剂组；或 E2 1mg/天+NETA 0.5mg/天，持续 4 个月，然后是 2 个月安慰剂组。在基线时以及 2、4 和 6 个月时，使用 Blatt-Kupperman 绝经指数评估更年期症状。采用卡方检验或 Fisher 检验进行分类数据的统计评估，采用 Kruskal-Wallis 检验进行数值数据的统计评估，采用方差分析进行时间和组与 Blatt-Kupperman 绝经指数关系的统计评估。
我们随机分配了 60 名女性（每组 20 名），其中 54 名完成了研究。结果发现，与基线相比，低剂量 HT 治疗期间，全 Blatt-Kupperman 绝经指数和热潮红评分在 HT 组中均无显著变化；然而，在低剂量-HT 停药后 2 个月的评估中发现，全 Blatt-Kupperman 绝经指数和热潮红评分与突然停药组相似，且明显高于基线水平（热潮红评分：在所有三组中，第 2、4 和 6 个月时与基线相比均为 p<0.001）。
通过减少雌激素的日剂量持续 2 或 4 个月来停止 HT，在血管舒缩症状方面的效果与突然停药没有区别。
