Menopause hormone therapy
One RCT (with a low risk of bias) in women after breast cancer found that tibolone (2.5mg/d) was associated with an improvement in sleep quality compared with placebo (LIBERATE study).35 An earlier analysis from the LIBERATE study reported insomnia as an adverse event, but did not report between-group differences.34 Another RCT (with a high risk of bias) found that menopause hormone therapy (oestradiol ± progestogen) improved sleep compared with no treatment.78 [ES21]
One RCT (with a moderate risk of bias) assessed the effect of menopause hormone therapy (sequential or continuous combined oestrogen/progestogen ) and acupuncture on sleep, and found that hormone therapy improved sleep relative to baseline, but did not report between-group differences.37 [ES21]
One RCT (with a high risk of bias) identified in a Systematic Review (with a low risk of bias) in postmenopausal women (including women surgically treated for breast cancer) found that tibolone (2.5 mg/d for more than two years) did not reduce the frequency of insomnia compared with placebo.38 [ES51]