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The aim of a recently published study was to determine the efficacy and tolerability of low-dose oral 17β-estradiol and low-dose venlafaxine extended release in alleviating vasomotor symptoms (VMS) [1]. In total, 339 perimenopausal and postmenopausal women (42–62 years old, mean age 55 years) with at least two bothersome VMS per day (mean 8.1 per day) were followed for 8 weeks. Participants were randomized to double-blind treatment with low-dose oral 17β-estradiol (0.5 mg/day) ([i]n[/i]  =  97), low-dose venlafaxine hydrochloride extended release (75 mg/day) ([i]n[/i]  =  96), or placebo ([i]n[/i]  =  146). Compared with baseline, the mean VMS frequency at week 8 decreased to 3.9 (95% CI 2.9–4.9) VMS per day (52.9% reduction) in the estradiol group, to 4.4 (95% CI 3.5–5.3) VMS per day (47.6% reduction) in the venlafaxine group, and to 5.5 (95% CI 4.7–6.3) VMS per day (28.6% reduction) in the placebo group. Treatment satisfaction was highest (70.3%) for estradiol, lowest (38.4%) for placebo, and intermediate (51.1%) for venlafaxine. Both interventions were well tolerated.


  • Amos Pines
    Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel


  1. Joffe H, Guthrie KA, LaCroix AZ, et al. Low-dose estradiol and the serotonin-norepinephrine reuptake inhibitor venlafaxine for vasomotor symptoms: A randomized clinical trial. JAMA Intern Med 2014 May 26. Epub ahead of print
  2. Speroff L, Gass M, Constantine G, Olivier S; Study 315 Investigators. Efficacy and tolerability of desvenlafaxine succinate treatment for menopausal vasomotor symptoms: a randomized controlled trial. Obstet Gynecol 2008;111:77-87
  3. Simon JA, Portman DJ, Kaunitz AM, et al. Low-dose paroxetine 7.5 mg for menopausal vasomotor symptoms: two randomized controlled trials. Menopause 2013;20:1027-35
  4. Notelovitz M, Lenihan JP, McDermott M, Kerber IJ, Nanavati N, Arce J. Initial 17β-estradiol dose for treating vasomotor symptoms. Obstet Gynecol 2000;95:726-31
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