We found that HRT did not improve sleep quality or general
quality of life in women who still had own hormone production
(=perimenopausal) or that of women in late postmenopause,
with no or only mild vasomotor symptoms. Previous studies
have shown that women with climacteric vasomotor symptoms
will benefit from HRT (Polo-Kantola et al. 1998). However,
a recent study by Young et al (2003) showed that postmenopausal
women using HRT had a lower objective sleep quality compared
to those without HRT.
As some studies have suggested that the use of HRT in late
menopause may have serious side effects (Women’s health
Initiative, 2002), we conclude that HRT should not be used
to relieve sleep problems in climacterically asymptomatic
or very low symptomatic perimenopausal, menstruating women
or in climacterically asymptomatic or very low symptomatic
late postmenopausal women. For women with climacteric vasomotor
symptoms HRT should be initiated as primary treatment for
insomnia, and the substitution should be continued for at
least three months before other treatment options would be
considered.
