On March 19th WHRI member Dr. Jerilynn C. Prior presented the results of her study “OR25-7: Oral Micronized Progesterone Beneficial for Perimenopausal Hot Flushes/Flashes and Night Sweats” at the Endocrine Society in Chicago, Illinois. The CIHR-funded study sought to address the gap for effective therapies to treat hot flushes and night sweats in perimenopausal women.
Perimenopause refers to the period of time during which the body begins to transition into menopause and fluctuating levels of estrogen affect the regularity of menstruation and ovulation. Eighty percent of perimenopausal women experience hot flushes and night sweats. In order to treat these symptoms women are often prescribed the birth control pill (an estrogen-based therapy), despite a lack of scientific evidence that this is an effective treatment option. Furthermore, age and weight gain can contribute to an increased risk for blood clots and stroke when taking this type of birth control.
“Almost a quarter of all women today are in perimenopause,” explains Dr. Prior. “They are often working as well as maintaining a home and caring for children and elders. About twenty percent of them will need effective treatment for hot flushes and night sweats in order to continue to be productive.”
To address this gap she looked to oral micronized progesterone (Progesterone). When women transition from pre- to perimenopause their estradiol levels increase and estrogenbirth control pills are no longer effective in suppressing them. Progesterone has shown to be effective as a treatment for menopausal women experiencing hot flushes and night sweats, and does not increase the risk for blood clots or stroke.
A group of one hundred eighty-nine perimenopausal women (who had menstruated in the last year) were randomized into two groups to test the efficacy of Progesterone as a treatment option over a three-month period. In the first group ninety-three women were given Progesterone to be taken at bedtime each day; the remaining ninety-six were given a Placebo. The study was the first randomized controlled trial of vasomotor symptoms treatment in a group consisting solely of perimenopausal women, and also included women in early perimenopause who have never skipped a period.
The participants were trained to keep a Daily Perimenopause Calendar via online video on the CeMCOR site. In the calendar women recorded the frequency and intensity of their hot flushes and night sweats, as well as perceived changes to their symptoms over the course of the three month trial.
While both groups reported a decrease in hot flushes and night sweats at the end of the trial, the results were not statistically different. However, women taking Progesterone versus Placebo reported feeling that their symptoms had significantly improved.
Based on the study, a similar study in menopausal women, and existing literature, Progesterone is likely to be a safe treatment option for night sweats and hot flushes in perimenopausal women.
Dr. Prior’s full abstract will be available in the Endocrine Society’s journal, Endocrine Reviews.