Mendoza 2000.

Methods	Parallel‐group RCT
Participants	76 hysterectomised women < 50 years old. Excluded if had had any previous malignant gynaecological process, oestrogen‐producing tumour, endocrinological or metabolic problems, cardiovascular disease, uncontrolled hypertension, active hepatic disease, serious skin illness, intestinal sickness or chronic obstructive respiratory disease. Patients with psychiatric problems or receiving anxiolytic or antidepressive drugs were also excluded Unclear whether all women were symptomatic
Interventions	Tibolone 2.5 mg per day (n = 38) Transdermic 17β‐oestradiol 50 micrograms per day (n = 38) Administered for 1 year
Outcomes	Climacteric symptoms through a modified version of the Kupperman Index Vasomotor symptoms measured as frequently (2), occasionally (1) or never (0) Reports binary measure of "reduction in vasomotor symptoms" Dyspareunia reported as part of a composite outcome of sexual symptoms (“behavioural changes”), which included libido
Notes	Timing: Feb 1, 1995, to January 31, 1996 Trial location: Nicaragua Multi‐centre: no; single site
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Table of random numbers with simple blind randomisation
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding of participants and personnel (performance bias) All outcomes	High risk	No mention of blinding
Blinding of outcome assessment (detection bias) All outcomes	High risk	Blinding of participants and personnel not stated and therefore unlikely
Incomplete outcome data (attrition bias) All outcomes	High risk	14/76 participants interrupted or changed therapy, or were lost to follow‐up; 6/76 did not start therapy
Selective reporting (reporting bias)	Unclear risk	Study protocol not available
Conflict of interest	Unclear risk	No information provided