EVALUATING THE EFFICACY OF HORMONAL VERSUS NON-HORMONAL THERAPY IN MANAGING MENOPAUSAL SYMPTOMS AMONG MIDDLE AGED WOMEN
Bibliographic record
Abstract
Background: The management of menopausal symptoms remains a central issue in women's health, with menopausal hormone therapy (MHT) and various non-hormonal alternatives constituting the primary therapeutic avenues. A synthesis of contemporary, high-quality evidence directly comparing their efficacy is needed to inform clinical decision-making. Objective: This systematic review aims to compare the efficacy of hormonal therapy versus non-hormonal therapies in managing vasomotor and other key menopausal symptoms among middle-aged women. Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for randomized controlled trials (RCTs) published between 2014 and 2024. Inclusion criteria focused on RCTs comparing systemic MHT to non-hormonal therapies (e.g., SSRIs, SNRIs, CBT) for menopausal symptoms in perimenopausal or postmenopausal women. Data extraction and risk of bias assessment were performed independently by two reviewers using the Cochrane RoB 2 tool. Results: Eight RCTs (n=1,842 participants) were included. Meta-analysis of five studies showed MHT provided a significantly greater reduction in vasomotor symptom frequency (MD -1.8 episodes/day, 95% CI -2.4 to -1.2; p<0.001) compared to SNRI/SSRI therapy. However, cognitive behavioral therapy (CBT) demonstrated comparable long-term efficacy to transdermal estradiol. Non-hormonal therapies were associated with greater improvements in psychological quality of life domains in some studies and a differentiated adverse event profile. Conclusion: MHT is the most effective intervention for rapid vasomotor symptom relief. Non-hormonal therapies, particularly CBT, are viable alternatives, achieving comparable long-term results and offering benefits for psychological well-being. Treatment choice should be individualized based on symptom profile, risks, and patient preference. Further long-term comparative studies are warranted.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".