[Parameters of lipid metabolism in postmenopausal women on oral or transdermal hormone replacement with or without progesterone].
OBJECTIVE
Aim of the study was to show different influences of transdermal and oral hormone replacement therapies (conjugated and micronized estrogens) with or without varying dosages of C21-progestogens on serum lipids and lipoproteins.


METHODS
We report on serum triglycerides, cholesterol, HDL-, LDL-cholesterol, apolipoprotein A 1 and B levels of 80 postmenopausal women, who received hormone replacement therapies for more than one year.


RESULTS
All patients showed increasing (non-significant) serum HDL/LDL-cholesterol-ratios. Transdermal estrogen monotherapy also influenced the lipid parameters in a positive way. Apolipoprotein B, cholesterol and LDL-Cholesterol decreased, apolipoprotein A 1 increased. Transdermal replacement therapy combined with C21-progestagens and all oral therapies resulted in HDL-cholesterol increases. Positive changes in lipid parameters were most remarkably in women receiving oral therapies. The addition of 42 mg medrogestone/cycle caused a more significant decrease of cholesterol serum levels than higher dosages of medrogestone did. During subsequent treatment cycles, serum triglycerides showed increasing levels within the reference limits in women receiving conjugated estrogens and medrogeston.


CONCLUSIONS
Transdermal and oral hormone replacement therapies with and without C21-progestogens are ideal for hormone replacement therapy in postmenopausal women with normal or minor pathological lipid parameters. The lowest possible medrogestone dose necessary for endometrium protection should be used.
Foth
D
D
Universitätsfrauenklinik Köln. dfoth@t-online.de
Römer
T
T
Benthin
A
A
D000279:Administration, Cutaneous; D000284:Administration, Oral; D001054:Apolipoproteins A / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D004338:Drug Combinations; D004394:Dydrogesterone / Q000494:pharmacology; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004967:Estrogens / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008524:Medrogestone / Q000494:pharmacology; D008875:Middle Aged; D017698:Postmenopause; D011372:Progestins / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D001054:Apolipoproteins A; D001055:Apolipoproteins B; D004338:Drug Combinations; D004967:Estrogens; D008055:Lipids; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D011372:Progestins; D014280:Triglycerides; D008524:Medrogestone; D004394:Dydrogesterone