Objective: To study long-term compliance with oral hormonal replacemen
t therapy (HRT). Methods: A total of 151 early postmenopausal women we
re initially randomly allocated to three groups in a double-blind, pla
cebo controlled trial, Fifty women received continuous combined therap
y, another 50 were placed on sequential therapy, while the remaining 5
1 women were given placebo for 2 years with no subsequent therapy. Aft
er 2 years of the trial, the women were followed in an open investigat
ion for a total of 8 years. Results: After 8 years, 112 (85%) women we
re interviewed. None of the women in the combined group had changed to
other therapies (46% were still in treatment), 32% were still being t
reated with sequential therapy and 18% had changed to other HRTs (main
ly because the women disliked the monthly bleeding induced). Of the pl
acebo group, 18% had started HRT while 53% still did not receive any t
herapy. Of the women who had taken combined therapy for 5 years, 95% w
ere still in therapy at the 8-year stage. Of the 25 women who had take
n sequential therapy for 5 years, 52% continued until the 8-year stage
and a further 16% received other types of HRT. The women who changed
HRT switched to continuous combined therapy. Conclusion: The continuou
s combined treatment might provide an alternative to sequential treatm
ent in postmenopausal women to achieve high long-term compliance.