Failure of the combination of sequential oral and transdermal estradiol plus norethisterone acetate to affect plasma homocysteine levels.
OBJECTIVE
A high level of plasma homocysteine may be deleterious to vascular health. We therefore compared the effect of combinations of sequential oral and transdermal estradiol plus norethisterone acetate on plasma homocysteine.


METHODS
Prospective, randomized study.


METHODS
Outpatient department of obstetrics and gynecology in a university hospital.


METHODS
Forty-two healthy, nonsmoking postmenopausal women starting hormone replacement therapy (HRT) to control climacteric symptoms.


METHODS
In a randomized order, the women started using either oral HRT (2 mg of estradiol on days 1-12, 2 mg of estradiol plus 1 mg of norethisterone acetate (NETA) on days 13-22, and 1mg of estradiol on days 23-28; n = 21) or transdermal HRT (50 microg/d of estradiol on days 1-28 and 250 microg/d of norethisterone acetate on days 15-28, n = 21) for 1 year.


METHODS
Fasting plasma levels of homocysteine were measured before the treatment and during the combined estradiol-plus-NETA phases of the sixth and 12th treatment cycles.


RESULTS
Basal homocysteine levels in the oral group (8.2 +/- 3.1 micromol/L, mean plusmn;SD) and transdermal group (8.7 plusmn; 1.8 micromol/L, mean plusmn;SD) were not affected by the estradiol-plus-NETA combination.


CONCLUSIONS
Neither an oral nor a transdermal combination of sequential estradiol and NETA causes significant changes in plasma homocysteine in Finnish postmenopausal women with normal baseline homocysteine levels.
Eviö
S
S
Department of Obstetrics and Gynecology, Helsinki, Finland.
Tiitinen
A
A
Turpeinen
U
U
Ylikorkala
O
O
D000279:Administration, Cutaneous; D000284:Administration, Oral; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009640:Norethindrone / Q000031:analogs & derivatives / Q000627:therapeutic use*; D000077563:Norethindrone Acetate; D011446:Prospective Studies
D006710:Homocysteine; D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone