Efficacy Comparison of Pueraria mirifica (PM) against Conjugated Equine Estrogen (CEE) with/without Medroxyprogesterone Acetate (MPA) in the Treatment of Climacteric Symptoms in Perimenopausal Women: Phase III Study
Verapol Chandeying MD*, Malinee Sangthawan MD**
Affiliation : * Faculty of Medicine, Prince of Songkhla University, Hat Yai, Songkla ** Hat Yai Regional Hospital, Hat Yai, Songkla
Objective : To evaluate the efficacy comparison of Pueraria mirifica (PM), name in Thai is Kwao Kruea Khao,
against conjugated equine estrogen (CEE) with/without medroxyprogesterone acetate (MPA) in the treat-
ment of perimenopuasal women with climacteric symptoms.
Materials and Methods : Perimenopausal women attending the Menopausal clinic of Hat Yai Regional Hospital
were voluntarily recruited. The vasomotor symptoms such as hot flushes and night sweats, as well as other
unpleasant symptoms, urogenital and psychological symptoms, were also assessed. Patients were voluntarily
enrolled and randomly received daily 50 mg raw material of PM, Group A, or daily 0.625 mg of conjugated
equine estrogen (CEE) with/without 2.5 mg of medroxyprogesterone acetate (MPA), Group B, depend on non-
hysterectomized/hysterectomized condition.
Results : Seventy-one patients were enrolled. Eleven of those were excluded for failing to complete the initial
work-up and follow-up. Sixty cases were evaluated, 30 cases in Group A and 30 cases in Group B. After
medication, the mean of modified Greene climacteric scale (MGCS) in Group A/Group B had decreased from
29.0/32.26 to 17.86/18.1, 12.56/9.57 and 9.9/8.16 at 1-, 3-, and 6- month respectively. The clinical satisfaction
using MGCS was not statistically significant between PM (Group A) and CEE with/without MPA (Group B) in
the alleviation of climacteric symptoms (p-value > 0.05,). There were no statistically significant changes of
three serum markers: estradiol, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) between
both groups.
Conclusion : PM, containing phytoestrogens, has estrogenic effect as similar as CEE, and can alleviate the
climacteric symptoms in perimenopausal women. PM demonstrates great promise in the treatment of climacteric
symptoms. However, optimal doses should be clinically assessed to meet appropriate individual responses.
Keywords : Pueraria mirifica, Conjugated equine estrogen, Medroxyprogesterone acetate, Vasomotor symptoms, Perimenopausal women, Phytoestrogen
