Serum lipoprotein effects of conjugated estrogen and a sequential conjugated estrogen-medrogestone regimen in hysterectomized postmenopausal women.

The progestogen chosen for addition to estrogen replacement is important because some progestins adversely influence the effects of oral estrogens on lipid metabolism. In this double-blind study, 22 estrogen-deficient hysterectomized women were treated initially for six cycles with either 0.625 mg conjugated equine estrogens for 21 days plus a placebo during the last 10 days of each cycle or the same estrogen regimen with 10 days of 5 mg medrogestone per day. Thereafter, the treatments were crossed over for a further six cycles. Levels of lipids, lipoproteins, and apolipoproteins were determined at baseline and the last day of sixth and twelfth treatment cycles. Conjugated equine estrogen monotherapy resulted is significantly increased levels of high-density lipoprotein cholesterol (p less than 0.01); percent high-density lipoprotein cholesterol (p less than 0.001), and high-density lipoprotein2-cholesterol (p less than 0.001), with significantly decreased total cholesterol (p less than 0.01), low density lipoprotein cholesterol, and atherogenic index (p less than 0.001). Medrogestone caused no attenuation of any of these clinically important lipoprotein changes. Therefore from the lipoprotein aspect medrogesterone is a desirable progestogen.

RCT Entities:   Population Interventions Outcomes