Long term influence of different postmenopausal hormone replacement regimens on serum lipids and lipoprotein(a): a randomised study

Abstract

Objective To assess the influence of three different postmenopausal hormone replacement therapies on Design Open, randomised, controlled study.Participants One hundred and forty healthy, early postmenopausal women.Interventions The women were randomised to receive continuous 17P-oestradiol, either orally (2 mg daily; n = 35) or transdermally (50 pg daily; n = 35), plus 10 mg dydrogesterone daily for 14 days of each 28-day cycle; or 2-5 mg tibolone daily (n = 35). Thirty-five untreated women acted as controls. Results At 24 months oral oestradiol increased mean HDL cholesterol (7%; 95% CI 1-14), compared with no change in the transdermal group and a decrease of 26.8% in the tibolone group (95% CI 22.9-30.5); oral oestradiol decreased mean LDL cholesterol (1 1.8%; 95% CI 6*3-19), compared with no change in the tibolone group. Changes in apolipoprotein A-1 and B showed a similar pattern to HDL and LDL cholesterol, respectively. Oral oestradiol increased serum triglycerides (30%; 95% CI 18-42) after 24 months, compared with no change in the tibolone and transdermal oestradiol groups. Tibolone decreased serum Lp(a) by 36.6% after 24 months (95% CI 8-3-56-2), oral oestradiol decreased levels by 29.4% (95% CI 2-5 1-1), compared with no change in the transdermal oestradiol group. Main outcome measures

Effects of sequential combined transdermal and oral hormone replacement therapies on serum lipid and lipoproteins in postmenopausal women

“…Oral treatment increased triglycerides levels, but not to statistical significant degree, consistent with reports from previous studies [13,16]. In contrast with oral treatment, transdermal treatment lowered serum triglycerides levels by 17% during the combined phase of the treatment.…”

Effects of non-oral postmenopausal hormone therapy on markers of cardiovascular risk: a systematic review

“…Control groups were not considered as such when subjects were assigned to them because they either refused or did not desire HT (69,72,73,87) or when they were just agematched controls for baseline comparison (28). For studies on sequentially combined HT regimens with monthly progestogen addition, changes measured during the combined phase were considered.…”

Effects of tibolone and cyclic hormone replacement therapy on glucose metabolism in non-diabetic obese postmenopausal women: a randomized study

“…While it relieves climacteric symptoms (19,20) and prevents postmenopausal osteoporosis (21,22), no endometrial proliferation occurs and amenorrhea is produced (23 -25). Because of its androgenic properties, TIB is effective in improving well-being and libido, but it has been shown to have an unfavourable effect on the serum lipid profile (26,27). However, only a few studies have been focused on its effects on insulin sensitivity and glucose metabolism (28 -30).…”