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Research Article| Volume 27, ISSUE 3, P275-284, July 1997

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Metabolic effect of two hormonal preparations in postmenopausal women

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      Abstract

      Objectives: To compare the metabolic and endocrinological effects of estradiol valerate/cyproterone acetate (Math Eq) to a regimen of conjugated estrogens/medroxyprogesterone acetate (Math Eq) in postmenopausal women. Methods: Lipid profile, endocrinological parameters, coagulation factors, renin and angiotensinogen were followed in postmenopausal women randomized to Math Eq or Math Eq during 12 cycles. Results: Following 12 cycles of treatment, total plasma cholesterol decreased more with Math Eq than with Math Eq. Low-density cholesterol decreased with Math Eq while it increased with Math Eq. High-density cholesterol remained fairly unchanged, and triglycerides increased significantly in both groups. Estradiol and estrone levels increased significantly more with Math Eq than with Math Eq while the sex-hormone-binding globulin increased more with Math Eq. Follicle stimulating and luteinizing hormone levels also decreased significantly. Total testosterone and dihydroepiandrosterone sulfate remained stable. Total levothyroxine serum levels increased significantly, but thyroid stimulating hormone and triiodothyronine levels remained stable. Coagulation parameters also remained stable. Angiotensinogen increased, while plasma renin activity and blood pressure remained unchanged. Conclusion: It is concluded that both Math Eq and Math Eq produce favourable metabolic effects. A better lipid profile, compatible with decreased cardiovascular risk, is observed with the Math Eq regimen. Higher circulating estrogen levels may explain in part this observation.

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      References

        • Kanell WB
        • Hjortland MC
        • McNamara PM
        • Gordon T
        Menopause and risk of cardiovascular disease. The Framingham Study.
        Ann Intern Med. 1976; 85: 447-452
        • Jensen J
        • Riis BJ
        • Christiansen C
        Cyproterone acetate, an alternative progestogen in postmenopausal hormone replacement therapy? Effects on serum lipids and lipoproteins.
        Br J Obset Gynaecol. 1987; 94: 136-141
        • Rijpkema AHM
        • van der Sanden AA
        • Ruijs AHC
        Effects of post-menopausal oestrogen-progestogen replacement therapy on serum lipids and lipoproteins: a review.
        Maturitas. 1990; 12: 259-285
        • Colditz GA
        • Stampfer MJ
        Cardiovascular effects of menopause and estrogen replacement: The epidemiological evidence.
        in: Swartz DP Hormonal Replacement Therapy. Williams and Wilkins, Baltimore1992: 109-138
        • Whitehead MI
        • King RJB
        • McQueen J
        • Campbell S
        Endometrial histology and biochemistry in climacteric women during estrogen and oestrogen/pregestogen therapy.
        J R Soc Med. 1979; 72: 322-327
        • Hirvonen E
        • Mälkönen M
        • Manninen V
        Effects of different progestogens on lipoproteins during postmenopausal replacement therapy.
        N Engl J Med. 1981; 304: 560-563
        • Schneider HPG
        • Schmidt-Gollwitzer K
        Clinical experiences with non-androgenic progestogen in an estradiol-valerate-containing regimen for hormone replacement therapy.
        in: Schneider HPG Genazzani AR New developments in Biosciences 7: A new approach to the treatment of climacteric disorders. Walter de Gruyter, Berlin-New York1992: 18-28
        • Mashchak CA
        • Lobo RA
        • Dozono-Takano R
        • Eggena P
        • Nakamura RM
        • et al.
        Comparison of pharmacodynamic properties of various estrogen formulations.
        Am J Obset Gynecol. 1982; 144: 511-529
        • Neuman F
        The physiological action of progesterone and the pharmacological effects of progestogens-a short review.
        Postgrad Med J. 1978; 54: 11-24
        • Lussier-Cacan S
        • Dubreuil-Quidoz S
        • Roederer G
        • Leboeuf N
        • Boulet L
        • et al.
        Influence of Probucol on enhanced LDL oxidation after fish oil treatment of hypertriglyceridemic patients.
        Arthrioscler Thromb. 1993; 13: 1790-1797
        • Campagnoli C
        • Lesca L
        • Cantamessa C
        • Peris C
        Long-term hormone replacement treatment in menopause: new choices, old apprehensions, recent findings.
        Maturitas. 1993; 18: 21-46
        • Harlap S
        The benefits and risks of hormone replacement therapy: An epidemiologic overview.
        Am J Obstet Gynecol. 1992; 166: 1986-1992
        • Hassager C
        • Riis BJ
        • Strøm V
        • Guyene TT
        • Christiansen C
        The long-term effect of oral and percutaneous estradiol on plasma renin substrate and blood pressure.
        Circulation. 1987; 76: 753-758
        • van Wersch JWJ
        • Ubachs JMH
        • van den Ende A
        • van Enk A
        The effect of two regimens of hormone replacement therapy on the haemostatic profile in postmenopausal women.
        Eur J Clin Chem Biochem. 1994; 6: 449-453
        • Volpe A
        • Facchinetti F
        • Grasso A
        • Petraglia F
        • Campanin D
        • et al.
        Benefits and risks of different hormonal replacement therapies in post-menopausal women.
        Maturitas. 1986; 8: 327-334
        • Crook D
        • Stevenson JC
        • Whitehead MI
        Estrogen replacement therapy and cardiovasular disease: Effects on plasma lipid risk markers.
        in: Swartz DP Hormonal Replacement Therapy. Williams and Wilkins, Baltimore1992: 139-169
        • Metka M
        • Hanes V
        • Heytmanek G
        Hormone replacement therapy: lipid responses to continuous combined oestrogen and progestogen versus oestrogen monotherapy.
        Maturitas. 1992; 15: 53-59
        • Tikkanen MJ
        Combination of estradiol valerate and cyproterone acetate-a modern regimen for hormone replacement therapy.
        in: Schneider HPG Genazzani AR New development in Biosciences 7: A new approach to the treatment of climacteric disorders. Walter de Gruyter, Berlin-New York1992: 9-15
        • Jensen J
        • Riis BJ
        • Strøm V
        • Christiansen C
        Long-term and withdrawal effects of two different oestrogen-progestogen combinations on lipid and lipoprotein profiles in post-menopausal women.
        Maturitas. 1989; 11: 117-128
        • Sherwin BB
        • Gelfand MM
        A prospective one-year study of estrogen and progestin in postmenopausal women: Effects on clinical symptoms and lipoprotein lipids.
        Obset Gynecol. 1989; 73: 759-766
        • Lobo RA
        • Pickar JH
        • Wild RA
        • Walsh B
        • Hirvonen E
        Metabolic impact of adding medroxyprogesterone acetate to conjugated estrogen therapy in postmenopausal women.
        Obset Gynecol. 1994; 84: 987-995
        • The Writing Group for the PEPI trial
        Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women.
        JAMA. 1995; 273: 199-208
        • Miller VT
        • Muesing RA
        • LaRosa JC
        • Stoy DB
        • Fowler SA
        • et al.
        Quantitative and qualitative changes in lipids, lipoproteins, apolipoproteins A-I, and sex hormonebinding globulin due to two doses of conjugates equine estrogen with and without a progestin.
        Obset Gynecol. 1994; 83: 173-179
        • Tikkanen MJ
        • Kuusi EA
        • Nikkilä E
        • Sipinen S
        Postmenopausal hormone replacement therapy: effects of progestogens on serum lipids and lipoproteins. A review.
        Maturitas. 1986; 8: 7-17
        • Bottiglioni F
        • de Aloysio D
        • Nicoletti G
        • Mauloni M
        • Mantuana R
        • et al.
        A study of thyroid function in the pre-and post-memopause.
        Maturitas. 1983; 5: 105-114
        • Chetkowski RJ
        • Meldrum DR
        • Steingold KA
        • Randle D
        • Lu JK
        • et al.
        Biologic effects of transdermal estradiol.
        N Engl J Med. 1986; 314: 1615-1620
        • Saleh AA
        • Dorey LG
        • Dombrowski MP
        • Ginsburg KA
        • Hirokawa S
        • et al.
        Thombosis and hormonal replacement therapy in postmenopausal women.
        Am J Obstet Gynecol. 1993; 169: 1554-1557