EFFECT OF PROGESTOGENS ON ESTROGEN-INDUCED LIPOPROTEIN CHANGES

A study was performed to evaluate the role of progestogens, on estroge n-induced changes in lipoprotein levels. Sixty postmenopausal symptoma tic women, aged 36-59, were included in the study. They were prospecti vely randomized to a sequential schedule (n = 20), 17beta-estradiol tr ansdermally 0.05 mg/day on days 1-24 and medroxyprogesterone acetate 1 0 mg/day orally on days 15-24 or a continuous schedule (n = 20), 17bet a-estradiol transdermally 0.05 mg/day and medroxyprogesterone acetate 2.5 mg/day orally on days 1-24. Patients who had total abdominal hyste rectomy + bilateral salphingooopherectomy (n = 20) received only 17bet a-estradiol 0.05 mg/day continuously. Serum total cholesterol (TC), hi gh density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL ) cholesterol and triglyceride (TG) levels were determined prior to an d at the 3rd, 6th and 9th month of therapy in all groups. Mean TC, TG and LDL cholesterol levels did not change significantly during therapy (P > 0.05). Only the mean HDL cholesterol levels showed significant i ncreases in all groups; from 42.30 +/- 9.97 mg/dl to 64.10 +/- 6.81 mg /dl in group I (P < 0.001), from 41.85 +/- 9.09 mg/dl to 60.65 +/- 7.4 1 mg/dl in group II (P < 0.001) and from 40.70 +/- 11.26 mg/dl to 58.8 0 +/- 7.74 mg/dl in group III (P < 0.001). It is concluded that medrox yprogesterone acetate, whether used continuously or sequentially, does not oppose the beneficial effects of transdermal 17beta-estradiol on the lipoprotein profile.