NEW YORK (Reuters Health) – The combination of estrogen and raloxifene seems to reduce menopausal symptoms and appears not to increase the risk of endometrial hyperplasia, researchers from Brazil report in the April 30th online issue of Menopause.

“Some physicians use the association of these two drugs in postmenopausal women and find satisfactory results,” Dr. Andrea Lucia Bastos Carneiro from Faculdade de Medicina da Universidade Federal de São Paulo, São Paolo, Brazil told Reuters Health in an email. “Preclinical studies show beneficial conclusions, while clinical studies available are short numbered, short term, and controversial in results. Therefore, more investigation is necessary to clarify the effects of the association of raloxifene and estrogen in postmenopausal women.”

Dr. Carneiro and colleagues summarized and analyzed 6 clinical trials of endometrial safety, menopausal symptoms, and vaginal complaints in healthy postmenopausal women using raloxifene and estrogen.

In the 5 studies that investigated the impact of this treatment on endometrial thickness, all but 1 of which lasted less than a year, there were small increases in endometrial thickness within a range thought to be of low risk (< 5 mm). Only 2 women in all the trials were reported to develop endometrial hyperplasia, both of them after 24 weeks of treatment.

All 6 trials reported menopausal symptoms, with most showing improved quality of life, satisfaction with the treatment, fewer vasomotor symptoms, and less vaginal dryness.

Heterogeneity of the trials limited the ability of the researchers to make thorough comparisons, and the low incidence of menopausal symptoms and small number of participants in each trial may have influenced the results.

“Adding different therapy options to postmenopausal treatment may be the way to effectively treat postmenopausal women,” Dr. Carneiro concluded. “Detailed screening and continued patient follow up are essential to early detection of adverse events, to enhance treatment compliance, and to better quality of life in postmenopausal women.”

Dr. Carneiro added, “There are several treatments for menopausal symptoms available, including the use of estrogens and progestogens – in different administration routes – phytoestrogens, SERMs, non-hormonal alternatives, etc. But the basic rule here is individualized therapy. So far, there is no one magic formula or gold standard treatment for the diverse conditions affecting postmenopausal women.”


Estrogens plus raloxifene on endometrial safety and menopausal symptoms-semisystematic review

Menopause 30 April 2012