Long-term and withdrawal effects of two different oestrogen-progestogen combinations on lipid and lipoprotein profiles in post-menopausal women.
Serum lipids and lipoproteins were studied in 86 healthy post-menopausal women at 3-monthly intervals throughout 2 yr of treatment with cyclic oestradiol valerate plus cyproterone acetate (E2V + CPA), continuous 17 beta-oestradiol plus norethisterone acetate (E2 + NETA), or placebo. Withdrawal effects were also investigated. Serum oestrogen levels were similar following the 2 hormone regimens. Serum total and low-density-lipoprotein (LDL) cholesterol were significantly reduced by 5-8% during cyclic E2V + CPA therapy and by 15-20% during continuous E2 + NETA treatment. The concentrations remained significantly reduced throughout the 2 yr of treatment. Virtually no changes were observed in the placebo group. High-density-lipoprotein (HDL) cholesterol concentrations were significantly reduced in relation to pretreatment values during the first year of continuous E2 + NETA therapy, but were not significantly different from the levels in the cyclic E2V + CPA or the placebo groups. Serum triglyceride levels remained almost constant in all the groups. Withdrawal of hormone therapy resulted in steep increases in total and LDL-cholesterol, the levels returning to pretreatment values. A similar increase in HDL-cholesterol was observed in the E2 + NETA group, following withdrawal. Vaginal bleeding episodes were experienced by all the women receiving the E2V + CPA regimen and they occurred regularly in 63% of the women. Fifty-two (52) percent of the women receiving E2 + NETA did not bleed at all. The results of the present study suggest that the continuous addition of NETA may enhance the oestrogen-induced changes in total and LDL-cholesterol, whereas only minor changes in the oestrogen-induced effects on these variables are produced by the cyclic addition of CPA. However, in the case of HDL-cholesterol, the antagonistic effect of CPA seems to be moderate in comparison with that of NETA.
Jensen
J
J
Department of Clinical Chemistry, Glostrup Hospital, University of Copenhagen, Denmark.
Riis
B J
BJ
Strøm
V
V
Christiansen
C
C
D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D002986:Clinical Trials as Topic; D003534:Cyproterone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D017373:Cyproterone Acetate; D004311:Double-Blind Method; D004338:Drug Combinations; D004958:Estradiol / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology*; D004966:Estrogens, Conjugated (USP) / Q000009:adverse effects / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D009640:Norethindrone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D000077563:Norethindrone Acetate; D011897:Random Allocation; D013375:Substance Withdrawal Syndrome; D013997:Time Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); D017373:Cyproterone Acetate; D004958:Estradiol; D000077563:Norethindrone Acetate; D003534:Cyproterone; D009640:Norethindrone