A QUALITY-OF-LIFE PERSPECTIVE ON WHO BENEFITS FROM ESTRADIOL REPLACEMENT THERAPY

Study objective. To examine who may benefit from estrogen replacement therapy from a quality of life (QoL) perspective, taking both disease-specific and general aspects at baseline into account. Design. A double-blind multi-center randomized placebo-controlled prospective study. The subjects were randomized to receive either transdermal estradiol or placebo for 12 weeks. QoL measures were disease-specific and generic. Location. University hospital, teaching hospital and private practice. Material. Post-menopausal volunteering Swedish women (n=223) with mild to severe climacteric symptoms, as clinically evaluated by the Kupperman's Index. Results. All QoL assessments showed highly significant improvement in the estradiol group in comparison with the placebo group. The women receiving placebo treatment also improved, but their improvement reached a peak at six weeks of treatment and then declined. In the estradiol group the improvement continued throughout the 12 weeks. After 12 weeks of treatment the change in the placebo-treated group was smaller on the disease-specific scales than on the generic scales and the Kupperman's Index. A high correlation was seen between the baseline score for a certain QoL assessment and the change in this score during treatment. The most striking result was that the mean change in QoL for the two groups was statistically significant for almost any pre-treatment QoL status. Conclusions. Women with slightly, moderately or severely diminished QoL status would benefit from estrogen treatment during the climacteric period. A similar tendency was seen in women with mild symptoms at baseline.