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In a presentation at the recent NAMS Congress, an analysis by Pinkerton and colleagues highlighted the effect of hormone therapy (HT) on hot flushes in women, regardless of their age or age at start of therapy. This was a post hoc analysis of data retrieved from five phase-3 trials (SMART trials), which gave the clinical basis for approval of the combination of conjugated estrogens and bazedoxifene back in 2013. These clinical trials included 3168 women in the HT arms (either CEE at 0.45 mg or 0.625 mg, plus 20 mg bazedoxifene) and 1241 women in the placebo arm. The focus of this new analysis was to determine whether the effects of the combination would differ, depending on when it was started in relation to menopause. Most of the women in the SMART trials were 40–75 years of age, white, and postmenopausal. Years since menopause ranged from 1 to 35 years, but the mean range was approximately 4–8 years. The analysis showed that menopausal symptoms improved to a similar degree, regardless of whether a woman started taking the combination less than 5 years after the start of menopause or more than 5 years after. Dr Pinkerton concluded that, whether the women started taking the combination sooner or later, there were no discernable differences in the reduction in bothersome hot flushes, prevention of bone loss, improvement in sleep, improvement in quality of life, or improvement in vulvovaginal changes.


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


  1. Hays J, Ockene JK, Brunner RL, et al. Effects of estrogen plus progestin on health-related quality of life. N Engl J Med 2003;348:1839-54
  2. Archer DF, Freeman EW, Komm BS, et al. Pooled analysis of the effects of conjugated estrogens/bazedoxifene on vasomotor symptoms in the Selective Estrogens, Menopause, and Response to Therapy Trials. J Womens Health (Larchmt) 2016 Sep 27
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