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Low-Dose Estrogen and Venlafaxine Similarly Effective for Menopausal Symptoms — Physician’s First Watch

Medical News |
May 27, 2014

Low-Dose Estrogen and Venlafaxine Similarly Effective for Menopausal Symptoms

By Amy Orciari Herman

Low-dose estradiol and venlafaxine are both effective treatments for vasomotor symptoms in menopausal women, a JAMA Internal Medicine study finds.

Some 340 peri- or postmenopausal women with bothersome vasomotor symptoms (hot flashes, night sweats) were randomized to receive low-dose estradiol (0.5 mg/day), low-dose venlafaxine (a serotonin-norepinephrine reuptake inhibitor; 75 mg/day), or placebo daily for 8 weeks.

Symptom frequency was reduced significantly more with estradiol (by 53%) and with venlafaxine (48%) than with placebo (29%). Both active treatments were well tolerated, although estradiol was more often associated with abnormal vaginal bleeding and venlafaxine with blood pressure increases.

The researchers note that "while the efficacy of low-dose estradiol may be slightly superior to that of venlafaxine, the difference is small and of uncertain clinical relevance." They conclude: "Treatment decisions should weigh the risk profile of each agent for each individual woman, taking into account her risk factor status and personal preferences regarding treatment options."

Reader Comments (3)

Goncalves de Melo, Jose Physician, Critical Care Medicine, Hospital Felicio Rocho, Belo Horizonte, MG, Br

I think, for being subjective, all antidepressants will work to reduce the symptoms!

Catherine Ratliff, JD, NCC Other, Other, Hot Springs, SD

After hot flashes for 15 years, gyn rx'd Effexor, could not tolerate but figured if that works, Fluoxetine has fewer s/e but may have similar SSRI. Prozac worked for me.

Robert Armbruster MD Internal Medicine, tucson

I don't think anyone is going to use unopposed estrogen for this problem, as none of my patients have the hot flashes for just 2 months! It also seems like a silly study, because we already know both meds work splendidly for hot flashes...

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