title: Effect of hormone replacement therapy and tibolone on serum total homocysteine levels in postmenopausal women.
abstract: OBJECTIVE
  To assess the effect of continuous combined hormone replacement therapy (HRT) or tibolone on serum total homocysteine (tHcy) levels in postmenopausal women.
  
  
  METHODS
  Ninety-five postmenopausal women aged 41-68 years were included in the study. Seventy-three women with climacteric complaints, osteopenia or osteoporosis received either conjugated equine estrogens 0.625 mg combined with medroxyprogesterone acetate 5 mg (CEE/MPA, n=31) or tibolone 2.5 mg (n=42). Twenty-two healthy women, matched for chronological and menopausal age, served as controls. Serum tHcy levels were assessed at baseline, 6, 12 and 18 months.
  
  
  RESULTS
  No difference was recorded between groups regarding demographic characteristics or mean baseline serum tHcy. Serum tHcy levels decreased significantly in the CEE/MPA compared to baseline (change at 18 months: -3.9%, P<0.05). The magnitude of the decrease was higher in the subgroup of women with baseline tHcy levels above the median (change at 18 months: -15.0%, P<0.01). No change in tHcy levels was detected in the tibolone group throughout the study period, either in the whole group (change at 18 months: 1.9%, NS) or in the subgroup with baseline tHcy levels above the median (change at 18 months: -3.23%, NS).
  
  
  CONCLUSIONS
  Continuous CEE/MPA reduces tHcy especially in women with high pretreatment tHcy levels. Tibolone has no effect on serum tHcy levels at least during the first 18 months of therapy. Larger studies with longer follow-up are required to confirm these results.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, 3 Neofytou Douka Street, Athens GR-10674, Greece. ilambrinoudaki@hotmail.com
authors.forename: George E
authors.initials: GE
authors.lastname: Christodoulakos
authors.forename: Constantinos P C
authors.initials: CP
authors.lastname: Panoulis
authors.forename: Irene V
authors.initials: IV
authors.lastname: Lambrinoudaki
authors.forename: Spyros G
authors.initials: SG
authors.lastname: Dendrinos
authors.forename: Demetrios A
authors.initials: DA
authors.lastname: Rizos
authors.forename: George C
authors.initials: GC
authors.lastname: Creatsas
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D005500:Follow-Up Studies; D006710:Homocysteine / Q000097:blood* / Q000187:drug effects*; D020249:Hormone Replacement Therapy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009652:Norpregnenes / Q000008:administration & dosage*; D017698:Postmenopause / Q000187:drug effects; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D009652:Norpregnenes; D006710:Homocysteine; C027385:tibolone