Effect of statins on estrogen and androgen levels in postmenopausal women treated with estradiol.
OBJECTIVE
A considerable number of postmenopausal women who receive estrogen therapy are also treated for hypercholesterolemia with cholesterol-lowering statins. Statins and steroid hormones can compete for the same steroid-metabolizing enzymes. We investigated whether long-term administration of statins had an effect on serum estrogen and androgen levels in postmenopausal women receiving and not receiving oral estrogen therapy.


METHODS
A subgroup analysis from the Estrogen in the Prevention of Atherosclerosis Trial, a randomized, double-blind, placebo-controlled trial, was performed. A total of 222 women were randomized to receive either placebo or 1 mg of oral micronized 17β-estradiol daily for 2 years. In both the placebo and treatment groups, participants with low density lipoprotein cholesterol levels >160 mg/dl were treated with statins. Blood samples were obtained at baseline and every 6 months during the trial. Serum levels of dehydroepiandrosterone, androstenedione, testosterone, estrone and 17β-estradiol were measured by radioimmunoassay.


RESULTS
Among 86 placebo- and 90 estradiol-treated subjects with baseline and on-trial hormone measurements, no significant differences were observed between the statin-free and statin-treated groups in mean changes from baseline to on-trial levels in any of the androgens or estrogens, whether or not the postmenopausal women were treated with estrogen.


CONCLUSIONS
The results suggest that estrogen therapy and statins can be used simultaneously with no deleterious effects on circulating hormone levels.
Peck
A
A
Departments of Obstetrics and Gynecology, University of Southern California Keck School of Medicine, Los Angeles, CA 90093, USA.
Chaikittisilpa
S
S
Mirzaei
R
R
Wang
J
J
Mack
W J
WJ
Hodis
H N
HN
Stanczyk
F Z
FZ
D008078:Cholesterol, LDL / Q000097:blood; D004311:Double-Blind Method; D004958:Estradiol / Q000627:therapeutic use*; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008875:Middle Aged; D017698:Postmenopause
D008078:Cholesterol, LDL; D004967:Estrogens; D012739:Gonadal Steroid Hormones; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D004958:Estradiol
Clin Ther. 1992 Sep-Oct;14(5):699-707
1345259
Drug Metab Dispos. 2002 May;30(5):505-12
11950779
Climacteric. 2003 Dec;6(4):330-6
15006254
Ann Intern Med. 2001 Dec 4;135(11):939-53
11730394
J Anim Sci. 1988 Dec;66(12):3160-73
3068221
Arch Intern Med. 2000 Aug 14-28;160(15):2273-80
10927723
J Steroid Biochem. 1982 Jun;16(6):801-10
7202083
Atherosclerosis. 1999 Feb;142(2):415-23
10030394
J Clin Endocrinol Metab. 1973 May;36(5):867-79
4349047
Endocr Rev. 1982 Summer;3(3):299-329
6288367
Nature. 1990 Feb 1;343(6257):425-30
1967820
Atherosclerosis. 1999 Mar;143(1):55-73
10208480
J Clin Endocrinol Metab. 1999 Oct;84(10):3666-72
10523012
Cancer Epidemiol Biomarkers Prev. 2002 Oct;11(10 Pt 1):1065-71
12376508
Z Kardiol. 2004 Jan;93(1):43-8
14740240
J Atheroscler Thromb. 2003;10(3):160-4
14564085