Drugs for the treatment of menopausal symptoms

Figures & data

Table 1. Estimated prevalence of menopausal symptoms [40].

	Pre- menopause	Peri- menopause	Post- menopause
Hot flashes and night sweats	14 – 51%	35 – 50%	30 – 80%
Vaginal dryness	4 – 22%	7 – 39%	17 – 30%
Sleep disturbance	16 – 42%	39 – 47%	35 – 60%
Mood symptoms	8 – 37%	11 – 21%	8 – 38%
Urinary symptoms	10 – 36%	11 – 21%	8 – 38%

Table 2. Commonly used doses of estrogen and progestogen therapy.

	Dosage
	High	Standard	Low	Ultra-low
Estrogens
Oral conjugated equine estrogens	1.25 mg	0.625 mg	0.3 mg
Oral micronized 17β-estradiol	4.0 mg	2.0 mg	1.0 mg	0.5 mg
Oral estradiol valerate		2.0 mg	1.0 mg
Oral piperazine estrone sulphate	1.25 mg	0.625 mg
Transdermal 17β-estradiol patch	100 μg	50 μg	25 μg	14 μg*
Subcutaneous implant estradiol	100 mg	50 mg	20 mg
Vaginal
Estriol		1 mg/g	0.5 mg
Estradiol		25 μg		10 μg
Transdermal estradiol gel		1 mg/1 g
Nasal spray estradiol hemihydrate		150 μg/actuation
Oral progestogens
Norethisterone acetate	1 mg	0.5 mg
Medroxyprogesterone acetate	10 mg	2.5 – 5 mg	1.5 mg
Drospirenone		2 mg
Dydrogesterone		10 mg
Micronized progesterone		200 mg
Other
Oral tibolone		2.5 mg	1.25 mg
Levonorgestrol intrauterine device		Releases levonorgestrol 20 μg/24 h

*14 μg 17β-estradiol is indicated only for prevention of osteoporosis.

Anderson GL, Limacher M, Assaf AR, Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA 2004;291(14):1701-12

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