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Randomised trial, 2000

Which progestin causes fewer mood problems during hormone replacement therapy?

Medroxyprogesterone caused fewer negative mood symptoms than norethindrone in women without PMS history. This randomized trial found both medications caused strong mood effects in women with a PMS history.

Moderate study design 51 postmenopausal women, some with a history of PMS

What they did

A double-blind crossover study of 51 postmenopausal women. Women received 2 mg estradiol continuously and either 10 mg medroxyprogesterone or 1 mg norethindrone for 12 days of each 28-day cycle, for 5 cycles. Daily mood and physical symptom rating scales were kept.

What they found

Both progestins caused mood to worsen during the late progestin phase and improve during the estrogen-only phase. Medroxyprogesterone was better for mood than norethindrone in women without a PMS history. In both groups, medroxyprogesterone caused more physical symptoms than norethindrone. Women with a PMS history responded strongly to both progestins. Symptoms improved over time but were still present after 5 months.

What it means for you

For women on hormone therapy without a PMS history, medroxyprogesterone may be better for mood. Women with a PMS history may struggle with either progestin. The study was small and included only postmenopausal women.

51

Number of women

10 mg vs 1 mg

Medroxyprogesterone versus norethindrone doses

5 cycles

Treatment duration (28 days per cycle)

About the study

Original title
Negative mood changes during hormone replacement therapy: a comparison between two progestogens
Authors
Björn I, Bixo M, Nöjd KS et al.
Journal
American journal of obstetrics and gynecology
Year
2000
Study design
Randomised trial
What was tested
Medroxyprogesterone acetate (10 mg) versus norethindrone acetate (1 mg)

Topics