Low-Dose HRT Cuts Hot Flashes, Protects Bones.

Fewer adverse effects seen with low-dose regimen, which may improve compliance.

WASHINGTON -- Low-dose HRT is as effective as conventional higher-dose therapy in decreasing both the number and severity of hot flashes and in raising bone density, speakers said in separate presentations at an international symposium on women's health and menopause.

Several different low-dose regimens provided rapid and sustained relief from vasomotor symptoms in a study comparing the treatments with placebo, said Dr. Joann V Pinkerton of the University of Virginia, Charlottesville.

She reported results from a sub-study of the Health, Osteoporosis, Progestin, Estrogen (HOPE) trial, a multicenter study involving 2,800 women nationwide. The purpose of the 2-year trial was to determine whether low-dose HRT is safe and effective.

The researchers hope their findings will eventually lead to better compliance with HRT and hence to more efficacious treatment. Women are more likely to comply with low-dose regimens, because they produce fewer adverse effects than conventional-dose HRT, she said at the symposium, sponsored by the National Institutes of Health, the International Menopause Society, and the North American Menopause Society.

The substudy involved 241 women with an average age of 52 years, who had experienced menopause at an average age of 48. Eighty-four percent were white.

All of the women had normal body weight and were highly symptomatic, with frequent and severe hot flashes. They were randomly assigned to receive conventional-dose (0.625 mg/day) or low-dose (0.45 or 0.3 mg/day) conjugated equine estrogens alone, or the same doses of estrogen plus one of two different doses (1.5 or 2.5 mg per day) of medroxy-progesterone acetate (MPA).