Finnish postmenopausal hormone therapy trial indicates

A postmenopausal hormone therapy trial conducted in Estonia indicates that hormone therapy does not improve women’s quality of life. The group receiving hormones and the comparison group showed no differences in general quality of life. Only those women that experienced hot flashes and night-time sweating reported beneficial effects. These results were obtained from the Estonian Postmenopausal Hormone Therapy trial (EPHT) funded by the Academy of Finland and conducted under the leadership of Research Professor Elina Hemminki from the National Research and Development Centre for Welfare and Health (Stakes).

The trial examined the effects of hormone therapy on utilisation of health care services, onset of illnesses, and well-being. In 1999–2001, 1,823 postmenopausal women aged 50 to 64 were recruited in the Tallinn and Tartu regions. The women took the research medication for 2 to 5 years. Estonia was selected for the trial because hormone therapy is already established in Finland and physicians have a very positive attitude towards its use. Hormone therapy is still rare in Estonia.

Hormone therapy led to an increased number of health care visits and increased treatment costs. In comparison to the control group, more lower abdominal ultrasounds and electrocardiograms were performed on the group receiving hormone therapy, but there were no differences in the number of gynaecological or breast surgeries, bone density measurement or mammography.

The women receiving hormone therapy showed slightly more cardiovascular disease, cerebral circulatory disease and cancer in comparison to the women who did not take hormones. However, these differences were not statistically significant. The hormone recipients had less fractures and less hot flashes and night-time sweating than the comparison group, but they also had more flow. There were no differences in depression, sleep disorders, fatigue, dizziness or bloating.

The EPHT trial is the first European randomised controlled long-term hormone therapy trial. The women in this trial were younger than those in the American WHI study completed earlier. Furthermore, the effect of postmenopausal hormones on use of healthcare services was studied for the first time. In addition to Stakes, other participants in the trial were the University of Tampere, the University of Tartu and the National Institute for Health Development (TAI) from Estonia.