Comparison of transdermal and oral estrogen-progestin replacement therapy: effects on cardiovascular risk factors.
OBJECTIVE
To determine the effects of oral and transdermal hormone replacement therapy on lipid profile and hemostatic factors in postmenopausal women.


METHODS
Twenty subjects were treated with oral E2 valerate (2 mg) combined with cyproterone acetate (1 mg) (group I) and 21 with transdermal E2 (1.5 mg) plus oral medroxyprogesterone acetate (5 mg) (group II). The effects on lipid profile and hemostatic parameters were evaluated at baseline and after 3, 6, and 12 months of treatment.


RESULTS
Group I showed a stronger increase of high-density lipoprotein (HDL) cholesterol levels (2-8%) and stronger reduction of atherogenic indices (total cholesterol/HDL cholesterol and low-density lipoprotein/HDL cholesterol) than group II. Group II showed a more pronounced reduction of triglyceride (21-31%) and factor VII (6-10%) levels than group I. Both groups showed reduced concentrations of total cholesterol, low-density lipoprotein cholesterol, tissue plasminogen activator, plasminogen activator inhibitor-1, antithrombin III, and protein S, whereas protein C was increased after 12 months of treatment.


CONCLUSIONS
The cardioprotective effects of hormone replacement therapy are demonstrated by favorable effects on lipid profile and fibrinolytic activity. Oral hormone replacement therapy showed a more prominent effect on lipoprotein metabolism than did transdermal administration, but transdermal medication had a stronger effect on triglyceride and coagulation factors. However, it needs to be considered that there is an increased risk of venous thrombotic events in the first year of treatment.
Chen
F P
FP
Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, Republic of China.
Lee
N
N
Soong
Y K
YK
Huang
K E
KE
D000279:Administration, Cutaneous; D000284:Administration, Oral; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D017373:Cyproterone Acetate / Q000008:administration & dosage; D004338:Drug Combinations; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015914:Estrogen Replacement Therapy; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006487:Hemostasis / Q000187:drug effects*; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D008875:Middle Aged; D045167:Progesterone Congeners / Q000008:administration & dosage; D012307:Risk Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D004338:Drug Combinations; D045167:Progesterone Congeners; C103294:estradiol valerate, cyproterone acetate drug combination; D017373:Cyproterone Acetate; D004958:Estradiol; D017258:Medroxyprogesterone Acetate