Structured Abstract

Contents

• Preface
• Acknowledgments
• Key Informants
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Background
  • Objectives
  • Key Questions
  • Analytic Framework
• Methods
  • Topic Refinement and Review Protocol
  • Literature Search Strategy
  • Inclusion and Exclusion Criteria
  • Study Designs—Inclusion and Exclusion Criteria
  • Study Selection Process
  • Data Extraction and Management
  • Evidence Tables
  • Quality Assessment of Individual Studies
  • Data Synthesis
  • Strength of the Body of Evidence
  • Applicability
  • Peer Review and Public Commentary
• Results
  • Overview
  • Key Question 1 Effectiveness of Different Treatments for Postmenopausal Symptoms
  • Key Question 2 Long-Term Effects of Menopausal Hormone Therapy Preparations
  • Key Question 3 Nonhormone Other Benefits/Harms
  • Key Question 4 Effectiveness of Treatments for Menopausal Symptoms in Selected Subgroups
• Discussion
  • Introduction
  • Symptom Relief
  • Other Benefits and Harms
  • Symptom Relief in Subgroups
  • Research Gaps
  • Implications for Clinical and Policy Decisionmaking
  • Limitations of the Comparative Effectiveness Review Process
  • Conclusions
• References
• Abbreviations
• Appendix A Literature Search Strategies
• Appendix B List of Excluded Studies
• Appendix C Abstraction Forms
• Appendix D Estrogen Dosing Categories
• Appendix E Evidence Base for Key Question 1
• Appendix F Vasomotor Symptom Supplemental Tables and Plots
• Appendix G Quality of Life Supplemental Tables and Plots
• Appendix H Psychological Symptoms Supplemental Tables and Plots
• Appendix I Sexual Function Plots
• Appendix J Urogenital Atrophy Supplemental Plots
• Appendix K Sleep Disturbance Plots
• Appendix L Quality Assessments From Nelson Report
• Appendix M Short-Term Adverse Effects for Nonhormone Therapies
• Appendix N Effectiveness of Treatments for Menopausal Symptoms in Selected Subgroups
• Appendix O Completed Clinical Trials From ClinicalTrials.gov

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2007-10058-I, Prepared by: Blue Cross and Blue Shield Association Technology Evaluation Center, Evidence-based Practice Center, Chicago, IL

Suggested citation:

Grant MD, Marbella A, Wang AT, Pines E, Hoag J, Bonnell C, Ziegler KM, Aronson N. Menopausal Symptoms: Comparative Effectiveness of Therapies. Comparative Effectiveness Review No. 147. (Prepared by Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. 290-2007-10058-I.) AHRQ Publication No. 15-EHC005-EF. Rockville, MD: Agency for Healthcare Research and Quality; March 2015. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10058-I). The findings and conclusions in this document are those of the authors, who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

AHRQ or U.S. Department of Health and Human Services endorsement of any derivative products that may be developed from this report, such as clinical practice guidelines, other quality enhancement tools, or reimbursement or coverage policies, may not be stated or implied.

This report may periodically be assessed for the currency of conclusions. If an assessment is done, the resulting surveillance report describing the methodology and findings will be found on the Effective Health Care Program Web site at www.effectivehealthcare.ahrq.gov. Search on the title of the report.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

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