Effects of adding C-19 versus C-21 progestin to conjugated estrogen in moderately hypercholesterolemic postmenopausal women.
OBJECTIVE
Our purpose was to compare the effects on fasting plasma lipoprotein lipids of adding low dosage C-19 continuous progestin (dl-norgestrel) versus conventional low-dosage continuous C-21 progestin (medroxyprogesterone acetate) to cyclic conjugated estrogen therapy.


METHODS
Nine hypercholesterolemic postmenopausal women with intact uteri were randomly assigned in a prospective, double-blind, two-period crossover study of conjugated estrogen plus either (1) dl-norgestrel (0.05 mg/day) or (2) medroxyprogesterone acetate (2.5 mg/day) for 1 year and after an appropriate washout period were switched to the alternative regimen for another year. Four subjects received conjugated estrogen only.


RESULTS
Compared with baselines, each of the C-19 and C-21 progestin regimens significantly increased plasma high-density lipoprotein cholesterol (15% vs 12%) and reduced the ratio of total cholesterol/high-density lipoprotein cholesterol (20% vs 15%, respectively), but only the former significantly reduced plasma triglycerides (24% vs 0.3%, p < 0.05).


CONCLUSIONS
Low dosages of either dl-norgestrel (C-19) or medroxyprogesterone acetate (C-21) when combined with conjugated estrogen significantly improve plasma lipoprotein lipids of postmenopausal women.
Wolfe
B M
BM
Department of Medicine, The University of Western Ontario, London, Canada.
Koval
J J
JJ
Nisker
J A
JA
D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D018592:Cross-Over Studies; D004311:Double-Blind Method; D015914:Estrogen Replacement Therapy; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage* / Q000627:therapeutic use; D009644:Norgestrel / Q000008:administration & dosage* / Q000627:therapeutic use; D017698:Postmenopause; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D004966:Estrogens, Conjugated (USP); D014280:Triglycerides; D009644:Norgestrel; D002784:Cholesterol; D017258:Medroxyprogesterone Acetate