Effects of estrogen and venlafaxine on menopause-related quality of life in healthy postmenopausal women with hot flashes. Issue 6 (June 2015)

• Record Type: Journal Article
• Authors: Caan, Bette; LaCroix, Andrea Z.; Joffe, Hadine; Guthrie, Katherine A.; Larson, Joseph C.; Carpenter, Janet S.; Cohen, Lee S.; Freeman, Ellen W.; Manson, JoAnn E.; Newton, Katherine; Reed, Susan; Rexrode, Kathy; Shifren, Jan; Sternfeld, Barbara; Ensrud, Kris
• Is Part Of: Menopause. Volume 22:Issue 6(2015)
• Publication Date: 2015-06
• Subjects: Menopause -- Periodicals; 618.175005
• DOI: 10.1097/GME.0000000000000364
• Languages: English
• ISSNs: 1072-3714

Abstract

<abstract> <title>Abstract</title> <sec> <title>Objective</title> <p>This study aims to evaluate the effects of low-dose estradiol (E<sub>2</sub>) or venlafaxine on menopause-related quality of life and associated symptoms in healthy perimenopausal and postmenopausal women with hot flashes.</p> </sec> <sec> <title>Methods</title> <p>A double-blind, placebo-controlled, randomized trial of low-dose oral 17β-E<sub>2</sub> 0.5 mg/day and venlafaxine XR 75 mg/day, versus identical placebo, was conducted among 339 women (aged 40-62 y) experiencing two or more vasomotor symptoms (VMS) per day (mean [SD], 8.07 [5.29]) who were recruited at three clinical sites from November 2011 to October 2012. The primary trial outcome, as reported previously, was frequency of VMS at 8 weeks. Here, we report on secondary endpoints of total and domain scores from the Menopause-Specific Quality of Life Questionnaire (MENQOL) and from measures of pain (Pain, Enjoyment in life, and General activity scale), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Questionnaire-7), and perceived stress (Perceived Stress Scale).</p> </sec> <sec> <title>Results</title> <p>Treatment with both E<sub>2</sub> and venlafaxine resulted in significantly greater improvement in quality of life, as measured by total MENQOL scores, compared with placebo (E<sub>2</sub>: mean difference at 8 wk, −0.4; 95% CI, −0.7 to −0.2; <italic>P</italic> < 0.001; venlafaxine: mean difference at 8 wk, −0.2; 95% CI, −0.5 to 0.0; <italic>P</italic> = 0.04). Quality-of-life domain analyses revealed that E<sub>2</sub> had beneficial treatment effects on all domains of the MENQOL except for the psychosocial domain, whereas venlafaxine benefits were observed only in the psychosocial domain. Neither E<sub>2</sub> nor venlafaxine improved pain, anxiety, or depressive symptoms, although baseline symptom levels were low. Modest benefits were observed for perceived stress with venlafaxine.</p> </sec> <sec> <title>Conclusions</title> <p>Both low-dose E<sub>2</sub> and venlafaxine are effective pharmacologic agents for improving menopause-related quality of life in healthy women with VMS.</p> </sec> </abstract>