CONJUGATED ESTROGENS COMBINED WITH SEQUENTIAL DYDROGESTERONE OR MEDROXYPROGESTERONE ACETATE IN POSTMENOPAUSAL WOMEN - EFFECTS ON LIPOPROTEINS, GLUCOSE-TOLERANCE, ENDOMETRIAL HISTOLOGY, AND BLEEDING

This double-blind comparison of oral conjugated estrogens combined wit h cyclical dydrogesterone or medroxyprogesterone acetate was conducted in post-menopausal women. In this 1-year, double-blind, randomized, p arallel-group, multicenter study, 41 postmenopausal women received 0.6 25 mg/day of conjugated estrogens plus 10 mg/day of dydrogesterone for 14 days/cycle; and 36 received 0.625 mg of conjugated estrogens plus 10 mg/day of medroxyprogesterone acetate for 14 days/cycle. Changes in lipid and lipoprotein parameters (predictive of reduced cardiovascula r risk) were significantly greater in patients receiving 0.625 mg of c onjugated estrogens plus 10 mg of dydrogesterone, Dydrogesterone had n o adverse impact on glucose tolerance, but circulating glucose levels significantly increased in patients receiving 0.625 mg of conjugated e strogens plus 10 mg of medroxyprogesterone acetate after glucose toler ance testing. Patients receiving conjugated estrogens (0.625 mg) plus dydrogesterone (10 mg) had significantly fewer days with bleeding (51. 90 +/- 27.52 days) and reduced duration of bleeding episodes (5.56 +/- .24 days) than patients receiving conjugated estrogens (0.625 mg) plu s medroxyprogesterone acetate (10 mg) (71.40 +/- 29.63 and 6.74 +/- 1. 91 days, respectively). Both regimens provided good endometrial protec tion and relieved somatic, psychosomatic, and psychological menopausal symptoms. Adverse events, vital signs, and clinical laboratory findin gs were similar for both groups. In combination with conjugated estrog ens, dydrogesterone induced a better cardiovascular risk factor profil e and induced less vaginal bleeding than medroxyprogesterone acetate.