The Clinical Study Of Effects Of Low Dose And Ultra Low Dose Hormone Replacement Therapy On The Quality Of Life In Perimenopausal Women

Objective:To evaluate the effect of low dose hormone replacement therapy(HRT)and ultra-low dose HRT on relieving menopausal symptoms and improving the quality of life in perimenopausal women,and compared the occurence of side-effect between two groups.Methods:This was a retrospective study enrolled 98 Chinese healthy perimenopausal women from January 2014 to December 2015.The participants were devided into two groupsaccording to the dose of HRT.43 women received oestradiol valerate 1mg daily foralways with dydrogesterone 10mg daily for 14 days from the twelfth day of menstrual cycle(low dose HRT group).The other 55 women received oestradiol valerate 0.5mg daily for always with the same dose dydrogesterone(ultra-low dose HRT group).The therapy had been maintained for 25 weeks.Assessments were performed at baseline and after 25 weeks of treatment.The score of 36-item Short Form Health Survey(SF-36),modified Kupperman Menopause Index(mKMI)and adverse effects such as mastodynia and metrorrhagia were documented.The serum levels of follicle stimulating hormone(FSH)and estradiol(E2)were detected.Physical(as height and weight)and gynaecological examination,TVS mammary ultrasonography or mammogram were performed before and after treatment.The differences before treatment between two groups,the differences before and after treatment in each group,and the differences between two groups after treatment were compared and analysed.Results:The mean(±SD)age of 98 perimenopausal women is 46.11(±4.03)years old.There were no significant difference on age,duration of amenorrhoea,weight,BMI,the serum levels of FSH,mKMI at baseline between two groups(P>0.05.After 25 weeks of treatment,the scores of the SF-36 increased significantly in both two groups(P<0.05).Compared to baseline,the mKMI decreased at week 4,13,25 in both two groups,(P<0.05).The levels of FSH decreased,wheras the levels of E2 increased in both two groups,P<0.05).The thickness of endometrium increased significantly in low dose HRT group(P<0.05),while it had no statistical significant change in the ultra-low dose HRT group(P>0.05).The weight of low dose HRT had no change(P>0.05).But the weight of ultra-low dose HRT has decreased(P<0.05).The incidence of mastodynia and metrorrhagia was low,and had no statistical difference between the two groups(P>0.05).Conclusions:Low dose HRT and ultra-low dose HRT had same effect in improving quality of life,alleviating perimenopausal symptoms,adjusting female sex hormone in perimenopausalwomen.The incidence of mastodynia and metrorrhagia was low in both groups.The thickness of endometrium of low dose HRT group increased and it had no change in the ultra-low dose HRT group.The weight of ultra-low dose HRT group decreased while it had no change in low does HRT group.To sum up,the ultra-low dose-HRT had the same therapeutic effect as low does HRT and it might have more advantages on weigh and the thickness of endometrium.This study is worthwhile in guiding and optimizing HRT treatment for perimenopausal women.