News
Hormone Battle: Prempro vs. Activella
A new hormone replacement therapy (HRT) for menopause causes less bleeding than Prempro, the most-prescribed HRT.
A report in the current issue of the journal Menopause shows that women who took Activella had less bleeding than women who took Prempro. Both of these HRTs are designed for long-term use by postmenopausal women who have not had a hysterectomy.
One of the biggest problems with Prempro and similar drugs is that women often have breakthrough bleeding. This means that they may have a small amount of menstrual-type bleeding but on an irregular basis. This often causes women to stop taking HRT.
University of Vermont researcher Julia V. Johnson, MD, led a head-to-head study comparing Prempro and Activella. The company that markets Activella in Europe funded the study.
"The patient taking [Activella] will receive effective treatment for her menopausal symptoms with less bleeding," Johnson and her co-authors write. Less than 30% of women taking Activella experienced bleeding, whereas 60% of the Prempro group bled.
Accompanying the report is an editorial by R. Don Gambrell Jr., MD, professor of endocrinology and obstetrics at the Medical College of Georgia, Augusta. Gambrell notes that the study shows Activella causes less bleeding during the first three cycles of treatment. After this time, there's not much difference between Activella and Prempro. But Gambrell suggests that even this slim advantage may mean that more women will continue their HRT if they start with Activella.
Gambrell also notes that both Activella and Prempro use a strategy called continuous combined HRT. This strategy -- the cause of the breakthrough bleeding -- is intended to reduce the chance that HRT will cause uterine cancer.
Gambrell writes that there are newer forms of HRT that seem to protect the uterus better than continuous combined HRT -- and with less bleeding.