Dydrogesterone does not reverse the cardiovascular benefits of percutaneous estradiol

Kuba, Valesca Mansur; Teixeira, Moema Amorim; Meirelles, Ricardo M.R.; Assumpção, Carmen Regina Leal de; Costa, Olivia S.

doi:10.3109/13697137.2012.672843

Cited by 6 publications

(3 citation statements)

References 28 publications

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“…The data suggested that continuously applied dydrogesterone in combined-HRT did not diminish the beneficial effects on lipid metabolism induced by estrogens. Similar results were observed in other studies [ 51 – 59 ]. Overall, when given in combination with estrogen, dydrogesterone does not have a large impact on estrogen effects.…”

Section: Clinical Effects Of Progestogens On Blood Lipids In Hrtsupporting

confidence: 93%

The effects of progesterones on blood lipids in hormone replacement therapy

Jiang

Tian

2017

Lipids Health Dis

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The safety of progestogens as a class has drawn much attention after the publication of data from the Women’s Health Initiative (WHI) trial, particularly with respect to cardiovascular disease. Depending on the chemical structure, pharmacokinetics, receptor affinity and potency of action, progestogens have a divergent range of properties that may translate to very different clinical effects. The purpose of this review is to describe the role of varied progestogens in hormone replacement therapy (HRT), especially focusing on blood lipids, which are the most important parameters for assessing cardiovascular disease risk.

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Section: Clinical Effects Of Progestogens On Blood Lipids In Hrtsupporting

confidence: 93%

The effects of progesterones on blood lipids in hormone replacement therapy

Jiang

Tian

2017

Lipids Health Dis

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“…One opinion is that progesterone, DG or 17-hydroxyprogesterone caproate are drugs that do not produce some of the adverse effects associated with other progestogens [ 20 ], and DG exerts endothelial anti-inflammatory actions (i.e., via a decrease in expression of leukocyte adhesion molecules) [ 20 ], perhaps linking with modulation of oxidative stress. Clinical studies have also found that DG treatment could improve oxidative stress conditions in combination with E2 [ 21 ]. The DG component offers endometrial protection and cycle control without negating the vasoprotective effects of E2 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Different Effects of Oral Contraceptive and Dydrogesterone Treatment on Oxidative Stress Levels in Premenopausal Women

Chen¹,

Kotani²

2018

J Clin Med Res

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BackgroundThe aim of the study was to observe the changes in blood oxidative stress levels by oral contraceptive (OC) and/or dydrogesterone (DG) treatment.MethodsA retrospective cohort of 27 premenopausal women with primary dysmenorrhea consisted of the OC treatment group (N = 17) and the DG treatment group (N = 10) by choice of the initial treatment. The OC group included two subgroups: patients with continuous OC treatment (treated for at least 15 months, N = 10) and patients with discontinuous OC treatment (switched to DG treatment after approximately 6 months of initial OC treatment: N = 7). The DG group had 15 months of continuous DG treatment. Blood parameters, including diacron-reactive oxygen metabolites (d-ROMs: an oxidative stress marker), were measured.ResultsThe d-ROMs level was elevated in the OC group 3 months after initial treatment (mean: from 321 (at baseline) to 512 Carratelli Units (Carr U); P < 0.01), while such changes were not observed in the DG group. The d-ROMs level was reduced in the discontinuous OC subgroup 15 months after initial treatment (from 508 (3 months after initial treatment) to 372 Carr U; P < 0.01), while such changes were not observed in the continuous OC subgroup. The DG group displayed unchanged the d-ROMs level.ConclusionReplacing OC with DG can attenuate oxidative stress as elevated by OC, thereby alleviating the possible vascular risks with OC treatment.

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“… 32 In a longitudinal analysis, metabolic parameters (lipid and glucose levels) were similarly improved among women treated for a least 2 years with transdermal estrogen with or without dydrogesterone, indicating no attenuation by dydrogesterone of estrogen-induced beneficial effects. 57 …”

Section: Special Situationsmentioning

confidence: 99%

Progestogens as a component of menopausal hormone therapy: the right molecule makes the difference

Stevenson¹,

Rozenberg²,

Maffei³

et al. 2020

DIC

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Optimizing menopausal hormone therapy (MHT) requires an awareness of the benefits and risks associated with the available treatments. This narrative review, which is based on the proceedings of an Advisory Board meeting and supplemented by relevant articles identified in literature searches, examines the role of progestogens in MHT, with the aim of providing practical recommendations for prescribing physicians. Progestogens are an essential component of MHT in menopausal women with a uterus to prevent endometrial hyperplasia and reduce the risk of cancer associated with using unopposed estrogen. Progestogens include natural progesterone, dydrogesterone (a stereoisomer of progesterone), and a range of synthetic compounds. Structural differences and varying affinities for other steroid receptors (androgen, glucocorticoid, and mineralocorticoid) confer a unique biological and clinical profile to each progestogen that must be considered during treatment selection. MHT, including the progestogen component, should be tailored to each woman, starting with an estrogen and a progestogen that has the safest profile with respect to breast cancer and cardiovascular effects, while addressing patient-specific needs, risk factors, and treatment goals. Micronized progesterone and dydrogesterone appear to be the safest options, with lower associated cardiovascular, thromboembolic, and breast cancer risks compared with other progestogens, and are the first-choice options for use in ‘special situations,’ such as in women with high-density breast tissue, diabetes, obesity, smoking, and risk factors for venous thromboembolism, among others.

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Dydrogesterone does not reverse the cardiovascular benefits of percutaneous estradiol

Abstract: Both HRT groups showed a reduction in their Framingham score. In contrast to data from other HRT investigations on cardiovascular risk, these formulations proved to be safe, even in the first year of use.

Cited by 6 publications

References 28 publications

The effects of progesterones on blood lipids in hormone replacement therapy

The effects of progesterones on blood lipids in hormone replacement therapy

Different Effects of Oral Contraceptive and Dydrogesterone Treatment on Oxidative Stress Levels in Premenopausal Women

Progestogens as a component of menopausal hormone therapy: the right molecule makes the difference

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