Main Article Content
clonidine, menopause, estrogen replacement therapy, health services research, pharmacoepidemiology
Following publication of the Women’s Health Initiative (WHI) study, many women discontinued use of estrogen replacement therapy. There is some evidence that the antihypertensive agent clonidine can reduce the frequency of hot flashes associated with menopause.
To determine the impact of the WHI study on incident use of clonidine in elderly women in Ontario, Canada.
Retrospective, population-based administrative database design. Data on all residents of Ontario over the age of 65 years were included. Time series methods were used to analyze change in incident clonidine use following publication of the WHI study.
Following publication of the WHI study, incident use of clonidine increased substantially among elderly women in Ontario, Canada. Similar trends were not observed for incident use of other antihypertensive medications.
During a period of time in which a large proportion of women discontinued estrogen replacement therapy, incident use of clonidine increased. There is some evidence that a small number of women may have sought alternative relief from menopausal symptoms using other pharmacological therapies.
2. Austin PC, Mamdani MM, Tu K, Jaakkimainen L. Trends in Use of Estrogen Replacement Therapy in Ontario, Canada Following Publication of the Women’s Health Initiative Study. Journal of the American Medical Association 2003;289:3241-3242.
3. Andre Picard. Risks prompt many Canadian women to stop hormone replacement therapy. The Globe and Mail Thursday, January 30, 2002; page A7.
4. Nagamani M, Kelver ME, Smith ER. Treatment of menopausal hot flashes with transdermal administration of clonidine. Am J Obstet Gynecol 1987;156:561-565.
5. Edington RF, Chagnon JP, Steinberg WM.Clonidine (Dixarit) for menopausal flushing. Canadian Medical Association Journal 1980;123:23-26.
6. Clayden JR, Bell JW, Pollard P. Menopausal flushing: Double-blind trial of a non-hormonal medication. British Medical Journal 1974;1:409-412.
7. Schindler AE, Muller D, Keller E, Goser R, Runkel F. Studies with clonidine (dixarit) in menopausal women. Archives of Gynegology 1979;227:341-7.
8. Laufer LR, Erlik Y, Meldrum DR, Judd HL. Effect of clonidine on hot flashes in postmenopausal women. Obstetrics & Gynecology 1982;60:583-6.
9. Wren BG, Brown LB. A double-blind trial with clonidine and a placebo to treat hot flushes. Medical Journal of Australia 1986;144:369-70.
10. Salmi T, Punnonen R. Clonidine in the treatment of menopausal symptoms. International Journal of Gynaecology & Obstetrics 1979;16:422-6.
11. van den Bosch WJ. The Dutch College of General Practitioners practice guideline “The menopause”; reaction from the field of general practice. Nederlands Tijdschrift voor Geneeskunde 2002;146:1309-1310.
12. Lucero MA, McCloskey WW. Alternatives to estrogen for the treatment of hot flashes. Annals of Pharmacotherapy 1997;31:915-7.
13. Shanafelt TD, Barton DL, Adjei AA, Loprinzi CL. Pathophysiology and Treatment of Hot Flashes. Mayo Clinic Proceedings 2002;77:1155-8.
14. Canadian Pharmacists Association. Compendium of pharmaceuticals and specialties. 36th ed. Ottawa: The Association; 2001.