Comparison of oral estrogens and estrogens plus androgen on bone mineral density, menopausal symptoms, and lipid-lipoprotein profiles in surgical menopause.
OBJECTIVE
To compare an oral estrogen-androgen combination with estrogens alone on bone, menopausal symptoms, and lipoprotein profiles in postmenopausal women.


METHODS
Surgically menopausal women received oral esterified estrogens (1.25 mg), or esterified estrogens (1.25 mg) and methyltestosterone (2.5 mg) daily, for 2 years. Bone mineral density of the lumbar spine and hip, menopausal symptoms, lipoprotein profiles, and biochemical and hematologic indices were evaluated.


RESULTS
Sixty-six patients were enrolled in the study. Both treatment regimens prevented bone loss at the spine and hip; combined estrogen-androgen therapy was associated with a significant increase in spinal bone mineral density compared with baseline (n = 24; mean score +/- standard error 3.4 +/- 1.2%, P < .01). In the estrogen group, high-density lipoprotein (HDL) cholesterol increased significantly and low-density lipoprotein cholesterol decreased significantly. Cholesterol, HDL cholesterol, and triglycerides decreased significantly in the estrogen-androgen group. Menopausal symptoms of somatic origin (hot flashes, vaginal dryness, and insomnia) were improved significantly by both treatments. Neither adverse hepatic effects nor significant safety or tolerance problems were reported in either group.


CONCLUSIONS
Oral estrogen-androgen increased vertebral bone mineral density compared with pre-treatment values and relieved somatic symptoms. Safety indices, including lipoprotein levels, indicated that the combination was well tolerated over the 2 years of treatment.
Watts
N B
NB
Emory University School of Medicine, Atlanta, Georgia.
Notelovitz
M
M
Timmons
M C
MC
Addison
W A
WA
Wiita
B
B
Downey
L J
LJ
D000284:Administration, Oral; D000328:Adult; D001053:Apolipoproteins / Q000187:drug effects / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects*; D002784:Cholesterol / Q000378:metabolism; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D045166:Estradiol Congeners; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004967:Estrogens / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005269:Femur / Q000378:metabolism; D006801:Humans; D007044:Hysterectomy; D008074:Lipoproteins / Q000187:drug effects / Q000378:metabolism; D008593:Menopause / Q000187:drug effects* / Q000378:metabolism; D008777:Methyltestosterone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D010052:Ovariectomy; D011184:Postoperative Period; D013131:Spine / Q000378:metabolism; D014280:Triglycerides / Q000378:metabolism; D014481:United States
D001053:Apolipoproteins; D045166:Estradiol Congeners; D004967:Estrogens; D008074:Lipoproteins; D014280:Triglycerides; C084328:Estratab; D002784:Cholesterol; D008777:Methyltestosterone