Metabolic effect of two hormonal preparations in postmenopausal women.
OBJECTIVE
To compare the metabolic and endocrinological effects of estradiol valerate/cyproterone acetate (EV/CPA) to a regimen of conjugated estrogens/medroxyprogesterone acetate (CE/MPA) in postmenopausal women.


METHODS
Lipid profile, endocrinological parameters, coagulation factors, renin and angiotensinogen were followed in postmenopausal women randomized to EV/CPA or CE/MPA during 12 cycles.


RESULTS
Following 12 cycles of treatment, total plasma cholesterol decreased more with EV/CPA than with CE/MPA. Low-density cholesterol decreased with EV/CPA while it increased with CE/MPA. High-density cholesterol remained fairly unchanged, and triglycerides increased significantly in both groups. Estradiol and estrone levels increased significantly more with EV/CPA than with CE/MPA while the sex-hormone-binding globulin increased more with CE/MPA. 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.


CONCLUSIONS
It is concluded that both EV/CPA and CE/MPA produce favourable metabolic effects. A better lipid profile, compatible with decreased cardiovascular risk, is observed with the EV/CPA regimen. Higher circulating estrogen levels may explain in part this observation.
Bissonnette
F
F
Department of Obstetrics and Gynecology, Université de Montréal, Hôpital Saint-Luc, Québec, Canada.
Lussier-Cacan
S
S
Fugère
P
P
Bérubé
S
S
D000808:Angiotensinogen / Q000097:blood; D001779:Blood Coagulation Factors / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002979:Climacteric / Q000187:drug effects*; D017373:Cyproterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D004734:Energy Metabolism / Q000187:drug effects*; D004958:Estradiol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D012083:Renin / Q000097:blood; D012307:Risk Factors
D001779:Blood Coagulation Factors; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004966:Estrogens, Conjugated (USP); D012739:Gonadal Steroid Hormones; D000808:Angiotensinogen; D017373:Cyproterone Acetate; D004958:Estradiol; D017258:Medroxyprogesterone Acetate; D012083:Renin