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Hormone therapy and sleep quality in women around menopause

Sarti, Costante Donati MD; Chiantera, Antonio MD; Graziottin, Alessandra MD; Ognisanti, Ferdinando MD; Sidoli, Cristina MD; Mincigrucci, Milena MD; Parazzini, Fabio MDGruppo di Studio IperAOGOI

doi: 10.1097/01.gme.0000172270.70690.5e

Objective: To obtain data on sleep quality in women attending menopause clinics in Italy.

Design: A cross-sectional study was conducted on the sleep quality of postmenopausal women attending a network of first-level outpatient menopause clinics in Italy for general counseling about menopause or treatment of its symptoms. Eligible for the study were women observed consecutively during the study period with natural or spontaneous menopause.

All participating centers enrolled women into the study who had never used hormone therapy (HT) (group 1, 819 women), current users of transdermal estrogens with or without progestins (group 2, 819 women), and current users of oral estrogens with or without progestins (group 3, 790 women). The women were asked about their quality of sleep using the Basic Nordic Sleep Questionnaire, their quality of life using the Short Form-12 questionnaire, and the intensity of hot flushes using a visual analogue scale.

Results: Women in groups 2 and 3 tended to report difficulties in sleeping less often than those in group 1. For example, never users of HT more frequently reported sleeping poorly and needed more time to sleep or had problems falling asleep; these differences were significant (P < 0.05). Otherwise, no difference emerged from the Basic Nordic Sleep Questionnaire between women in groups 2 and 3.

Conclusions: This study gives support to the suggestion that HT improves the quality of sleep. The effect was similar in women taking oral or transdermal therapy with or without progestins.

In this study, sleep quality in women attending menopause clinics in Italy were analyzed. Users of transdermal or oral estrogen with or without progestins tended to report difficulties in sleeping less than nonusers. This study supports the suggestion that hormone therapy improves the quality of sleep.

From the 1Scuola di Ostetricia e Ginecologia Ospedaliera, Azienda Ospedaliera di Perugia, Perugia; 2Ospedale Fatebenefratelli, Napoli; 3Centro di Sessuologia Medica e Ginecologia, Ospedale San Raffaele Resnati, Milano; 4Casa di Cura S. Pio X, Milano; and 5Prima Clinica Ostetrico Ginecologica, Università degli Studi di Milano, Milano, Italy.

Received November 5, 2004; revised and accepted April 13, 2005.

This study was partially supported by an educational grant of Rottapharm, Italia.

*Members of e Gruppo di Studio IperAOGOI are listed in the Appendix.

Address correspondence to: Fabio Parazzini, Prima Clinica, Osteteico Ginecologica, Università degli Studi di Milano, Milano Via Commenda 12. E-mail:

© 2005 by The North American Menopause Society.