COMPARISON OF ORAL ESTROGENS AND ESTROGENS PLUS ANDROGEN ON BONE-MINERAL DENSITY, MENOPAUSAL SYMPTOMS, AND LIPID-LIPOPROTEIN PROFILES IN SURGICAL MENOPAUSE

Objective: To compare an oral estrogen-androgen combination with estro gens alone on bone, menopausal symptoms, and lipoprotein profiles in p ostmenopausal women. Methods: Surgically menopausal women received ora l esterified estrogens (1.25 mg), or esterified estrogens (1.25 mg) an d methyltestosterone (2.5 mg) daily, for 2 years. Bone mineral density of the lumbar spine and hip, menopausal symptoms, lipoprotein profile s, and biochemical and hematologic indices were evaluated. Results: Si xty-six patients were enrolled in the study. Both treatment regimens p revented bone loss at the spine and hip; combined estrogen-androgen th erapy was associated with a significant increase in spinal bone minera l density compared with baseline (n = 24; mean score +/- standard erro r 3.4 +/- 1.2%, P < .01). In the estrogen group, high-density lipoprot ein (HDL) cholesterol increased significantly and low-density lipoprot ein cholesterol decreased significantly. Cholesterol, HDL cholesterol, and triglycerides decreased significantly in the estrogen-androgen gr oup. Menopausal symptoms of somatic origin (hot flashes, vaginal dryne ss, and insomnia) were improved significantly by both treatments. Neit her adverse hepatic effects nor significant safety or tolerance proble ms were reported in either group. Conclusion: Oral estrogen-androgen i ncreased vertebral bone mineral density compared with pre-treatment va lues and relieved somatic symptoms. Safety indices, including lipoprot ein levels, indicated that the combination was well tolerated over the 2 years of treatment.