Post-menopausal hormone replacement therapy: effects of progestogens on serum lipids and lipoproteins. A review

Tikkanen, Matti J.; Kuusi, Timo; Nikkilä, Esko A.; Sipinen, Seppo

doi:10.1016/0378-5122(86)90003-4

Cited by 77 publications

(18 citation statements)

References 44 publications

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“…However oral progestins can oppose favourable estrogen-induced changes in lipid and lipoprotein metabolism [20,37]. As with estradiol, several studies suggest that transdermal administration of progestins avoids the hepatic first-pass effect and effectively prevents endometrial hyperplasia without adverse effects on lipid-lipoprotein metabolism [40].…”

Section: Introductionmentioning

confidence: 99%

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

Şendağ

Karadadaş

Özşener

et al. 2002

Arch Gynecol Obstet

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The aim of this study was to compare the effects of sequential combined transdermal and oral postmenopausal hormone replacement therapies on serum lipid-lipoprotein profiles risk markers for cardiovascular disease. A prospective randomize study was designed: Ninety-six healthy nonhysterectomised postmenopausal women were randomized to receive either transdermal continuous 17beta-estradiol, 0.05 mg/d (Estraderm TTS, Novartis, Basel, Switzerland), with transdermal sequential norethisterone acetate, 0.25 mg/d (Estragest TTS, Novartis, Basel, Switzerland), or oral continuous conjugated equine estrogens, 0.625 mg/d (Premarin 0.625 mg, Wyeth, Philadelphia, U.S.A.), with oral sequential medroxyprogesterone acetate, 10 mg/d (Farlutal 5 mg, Deva, Istanbul, Turkey). 84 women completed the trial, 42 in oral and 42 in the transdermal group. The serum levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apolipoproteins AI and apolipoproteins B at 6 months after starting treatment were compared with baseline values for both therapies. Both oral and transdermal therapies significantly reduced serum levels of total cholesterol (208-190 mg/dL and 216-199 mg/dL, respectively, p=0.0001) and LDL-cholesterol (128-112 mg/dL and 140-127 mg/dL, respectively, p=0.001). The serum levels of triglycerides did not show any significant change with oral therapy, whereas this lipid fell (128-101 mg/dL, p=0.0001) significantly with transdermal therapy. We found significant decrease in HDL-cholesterol with transdermal therapy while there was no significant change with oral therapy. Apolipoproteins AI, the major protein component of HDL2 subfraction, was increased by oral therapy and lowered by transdermal therapy. As a conclusion, we have found that serum total cholesterol and LDL-cholesterol were lowered by both therapies, with no significant differences between treatments, whereas there were significant differences between treatments according to effects on serum triglycerides and apolipoproteins AI.

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Section: Introductionmentioning

confidence: 99%

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

Şendağ

Karadadaş

Özşener

et al. 2002

Arch Gynecol Obstet

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“…The consequences of such combined hormone replacement therapy on the occurrence of CHD are controversial. 3,4,6,29 -32 Progestagens can have adverse effects on lipoprotein concentrations 33,34 and negatively affect the beneficial effects of estradiol on atherosclerotic lesion formation. [35][36][37][38] Other investigations, however, showed no negative effect of progestagens on the beneficial effects of estrogen on the vessel wall.…”

mentioning

confidence: 99%

Tibolone Prevents Atherosclerotic Lesion Formation in Cholesterol-Fed, Ovariectomized Rabbits

Zandberg¹,

Peters²,

Demacker³

et al. 1998

ATVB

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Abstract-Tibolone (Org OD14), a synthetic steroid with estrogenic and progestogenic/androgenic properties, is clinically effective for the treatment of climacteric symptoms and the prevention and treatment of osteoporosis in postmenopausal women. The effect on atherogenesis, however, is not known. In the current study, we investigated the effect of tibolone in comparison with that of estradiol and norethisterone acetate on atherogenesis in 140 ovariectomized New Zealand White rabbits that had been induced by an atherogenic diet (0.4% cholesterol, 20 weeks). Tibolone at 18, 6, or 2 mg/d orally completely prevented cholesterol accumulation and fatty streak formation in the aorta; the impairment of endothelium-dependent smooth muscle relaxation of the aorta; and complex lesion formation after endothelial denudation in the carotid artery. Tibolone also reduced the increased postovariectomy plasma lipid concentrations. Analysis of the results, however, indicated that a substantial part of the strong, beneficial effects were plasma lipid independent. Compared with subcutaneous estradiol decanoate (150 g once weekly) and oral 17␤-estradiol (4 mg/d), the effects of tibolone were more pronounced at equipotent uterotropic activity. Norethisterone acetate (1 mg/d) did not affect atherosclerotic lesion formation. There are no indications that the progestogenic/androgenic properties of tibolone counteracted its atheroprotective effect on the vessel wall. Therefore, tibolone has the intrinsic potential to be a compound that protects the arterial vessel wall against atherosclerotic processes.

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“…Oestrogen replacement reverses these changes. Progestins may increase the activity of hepatic lipoprotein lipase and therefore increases the catabolism of HDL 2 , with the result of lowering the levels of HDL 2 and HDL-cholesterol 56. In addition, oestrogen with cyclically administered progestogen has little or no effect on triglycerides 53.…”

Section: Effects Of Oestrogen Deficiency (See Box 1)mentioning

confidence: 99%

The menopause and its treatment in perspective

Al‐Azzawi

2001

Postgraduate Medical Journal

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Post-menopausal hormone replacement therapy: effects of progestogens on serum lipids and lipoproteins. A review

Cited by 77 publications

References 44 publications

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

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

Tibolone Prevents Atherosclerotic Lesion Formation in Cholesterol-Fed, Ovariectomized Rabbits

The menopause and its treatment in perspective

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