MedicalResearch.com Interview with: Jerilynn C Prior MD FRCPC (on behalf of all authors Professor of Endocrinology / Department of Medicine University of British Columbia Centre for Menstrual Cycle and Ovulation Research www.cemcor.ca BC Women’s Health Research Institute Vancouver BC Canada MedicalResearch.com: What is the background for this study? Response: Night sweats and hot flushes/flashes (together called vasomotor symptoms, VMS) disturb women who are still menstruating (in perimenopause) are at least as much or more than  menopausal women (without flow for a year or more)¹. However, although studies have investigated various treatments for perimenopausal hot flushes/flashes, none have proven effective in these women who are also likely to be having heavy flow, breast tenderness, and premenstrual symptoms related to high and variable estrogen levels. These include randomized controlled trials (RCT) of the birth control pill², and gel estrogen in women using a progestin-releasing IUD³. Neither showed that therapy was more effective than placebo; both studied too few participants to provide a clear answer. Meanwhile, major medical organization guidelines recommend menopausal hormone therapy (MHT, usually of estrogen with a progestin) for any women younger than 60 years old who are bothered by night sweats and hot flushes ^4-6. However, there are no scientific RCT studies showing MHT is effective for perimenopausal night sweats and hot flushes. Giving more estrogen to someone whose own estrogen levels are often high, also did not make clinical sense. We previously performed an RCT showing that oral micronized progesterone (progesterone) was effective for menopausal hot flushes and also improved sleep⁷. Given that progesterone levels in perimenopausal women are declining, we considered that perimenopausal progesterone therapy for night sweats needed testing. (more…)