Comparative Effectiveness of Tibolone and Combined Hormone Therapy in Relieving Menopausal Insomnia.

Objective: This study explores the effectiveness of tibolone and combined hormone therapy (HT) in alleviating sleep disorders in women aged 40-65 who are in menopausal transition and postmenopause. Methods: The ambidirectional cohort study (retrospective 2011-2015; prospective 2016-2021), conducted at Shanghai Sixth People's Hospital's specialized menopause clinic. Participants were given tibolone or combined HT based on their STRAW + 10 stratification and preference for continued menstruation. Demographic information, baseline, and reevaluated performance of the Pittsburgh Sleep Quality Index (PSQI) were collected for analysis of their differentiations and impact factors. Sleep quality was reassessed 12 months after treatment initiation via PSQI. Results: The cohort study involved 285 participants-184 in the tibolone cohort and 101 in the combination HT cohort. After 12 months, PSQI scores improved by -3.76 ± 4.12 with tibolone and -3.66 ± 4.23 with combined HT. The adjusted between group difference was -0.359 (95% confidence interval = 0.577; p = 0.534). Conclusions: The study suggests that tibolone and combined HT improved sleep to a similar extent after adjustment. Further comprehensive research is necessary to corroborate these observations.