Effectiveness and Adverse Drug Reactions of Hormonal Replacement Therapy in Menopausal Women, Health Promotion Center, Region 4 Ratchaburi

Abstract

Objective To study and report the effect and adverse drug reactions (ADR) of 4 Hormonal replacement therapy (HRT) that prescribed to Health Promotion Center's patients. There are EV+NT (estradiol valerate 2.0 mg/tablet for 21 days plus norgestrel 0.5 mg/tablet for the last 10 days),CE (conjugated estrogens 0.625 mg/tablet), Tibolone 2.5 mg/tablet 28 days and CE+MT (conjugated estrogens 0.625 mg/tablet for 21 days and medrogestone 5.0 mg/tablet for the last 10 days).

Design Retrospective descriptive study.

Setting Health Promotion Center, Region 4, Ratchaburi, Thailand.

Subjects Menopausal women who recieved HRT from Health Promotion Center, Ratchaburi were included in this study. The subjects divided into 2 groups, group 1 continuous group, personal interview one hundred menopausal women who took HRT more than 3 months and group 2 missing group, mailed questionnaires to one-hundred and fourty three menopausal women who did not contact with Health Promotion Center more than 1 month.

Result After taking EV+NT(n=63) and CE(n=48) more than 4 weeks, the vasomotor symptoms, psychological symptoms, urogenital symptoms and musculo-skeletal symptoms decreased significantly (p<0.05), but after taking tibolone (n=19) more than 4 weeks, only vasomotor symptoms, psychological symptoms and urogenital symptoms decreased significantly (p<0.05), and CE+MT(n=7) had a few users, so it could not show significant. Breast tenderness was common adverse drug reaction of 4 HRT, EV+NT(41.3%), CE(50%), tibolone(31.6%) and CE+MT (57.1%). Return of monthly bleeding found in EV+NT (38.1%), CE+MT(14.3%) and tibolone (10.5%). Spotting found in EV+NT (9.5%) tibolone (21.0%) and CE+MT (14.3%). Weight gain found in EV+NT(28.6%), CE(22.9%), tibolone(10.5%), CE+MT (14.3%)and leg edema only found in tibolone (5.3%). Stop HRT 74.4% was a main cause of the missing group, and the reasons for stop HRT were on busy 28.7%, menopausal symptoms recovering 21.8%, ADR18.4%, fear of cancer 13.8%, lack of advice for continuous used 12.6% and financial problem for HRT 2.3%. 

Conclusion EV+NT and CE showed significantly more effective and more ADR than tibolone.