TRANSDERMALLY ADMINISTERED ESTRADIOL COMBINED WITH ORAL MEDROXYPROGESTERONE ACETATE - THE EFFECTS ON LIPOPROTEIN METABOLISM IN POSTMENOPAUSAL WOMEN

Objective To investigate the effects of two doses of transdermally app lied oestradiol on lipid and lipoprotein metabolism in climacteric wom en. Design A randomised double blind cross-over comparison. Setting De partments of Obstetrics and Gynaecology, Ostra and Sahlgren's Hospital , Goteborg and Karolinska Hospital, Stockholm, Sweden. Subjects Fifty- two women with climacteric symptoms were treated with oestradiol trans dermally applied (50 mug and 100 mug/24 h). A daily dose of 5 mg oral medroxyprogesterone acetate was added 14 days each treatment cycle of four weeks. Interventions Blood samples were drawn after an overnight fast before and after four and eight months of treatment. Main outcome measures Assays for serum triglycerides and cholesterol as well as lo w density lipoprotein (LDL) and high density lipoprotein (HDL) cholest erol including the subfractions HDL2 and HDL3 were performed. Results Significant decrements were found in triglycerides and serum and LDL c holesterol during treatment with both doses. A modest rise in HDL2 cho lesterol was observed after treatment with the 100 mug/24 h dose. Conc lusions The serum lipid and lipoprotein profile encountered in these w omen was similar to that reported with oral formulations except for a decrease in triglycerides. The metabolic differences between the two d oses of transdermal oestradiol is probably of minor clinical significa nce in normal postmenopausal women.