Menopausal symptoms after cessation of hormone replacement therapy

ObjectivesTo determine the prevalence of recurrent menopausal symptoms among post-menopausal women who discontinued hormone replacement therapy (HRT) after the publication of the women's health initiative (WHI) study and to describe the therapeutic strategies employed to address these symptoms.MethodsRetrospective analysis of 1000 post-menopausal women seen consecutively at an internal medicine practice from January 2004 to May 2004.ResultsAmong 1000 post-menopausal women, 205 (21%) had discontinued HRT due to the WHI results. Menopausal symptoms were present in 91/205 (44%) women, with 52/205 (25%) having vasomotor symptoms, 51/205 (25%) urogenital complaints, and 10/205 (5%) mood-related symptoms. Out of the 91 symptomatic women, only 55 (60%) received therapy to relieve their symptoms. The most commonly employed treatments were topical estrogen in 33/91 (36%) women, complementary therapies in 18/91 (20%) women, and venlafaxine in 13/91 (14%) women. Among complementary therapies, the most frequent were black cohosh used by 8/91 (9%) women and soy by 7/91 (8%) women.ConclusionsMany post-menopausal women developed typical menopausal symptoms after discontinuation of HRT, with vasomotor and urogenital complaints being the most commonly reported. Topical estrogen, complementary therapies, and venlafaxine were the most usual treatments for menopausal symptoms. However, a large number of symptomatic women remained untreated.