A RANDOMIZED CONTROLLED-STUDY OF THE EFFECTS OF 17BETA-ESTRADIOL-DYDROGESTERONE ON PLASMA HOMOCYSTEINE IN POSTMENOPAUSAL WOMEN

Objective: To investigate the effects of oral 17 beta-estradiol (E2)-d ydrogesterone on fasting plasma homocysteine concentrations in healthy postmenopausal women. Methods: We studied 27 postmenopausal women who were assigned randomly to either a treatment group (n = 14) or a cont rol group (n = 13), during the first 12 months of the study, treatment consisted of oral E2, 1 mg daily, combined sequentially with dydroges terone 5 or 10 mg (14 days per 28-day treatment cycle). Thereafter, wo men were treated with oral E2, 2 mg daily, combined sequentially with dydrogesterone, 10 mg daily (14 days per 28-day treatment cycle) for a period of 3 months. The control group received no treatment. Fasting plasma total homocysteine concentrations were determined at baseline a nd 3, 12 and 15 months after study entry. Results: At baseline, plasma homocysteine levels did not differ between the groups. After 15 month s of hormone treatment mean plasma homocysteine concentration was lowe red by 12.6% compared with baseline (P <.001; analysis of variance for repeated measures). Plasma homocysteine levels were not altered in th e control group. The interaction between treatment and time for homocy steine levels was significantly different between the groups (P <.001; analysis of variance for repeated measures). The decrease in plasma h omocysteine levels correlated inversely with the increase in serum E2 levels after 3 and 12 months of hormone treatment (r = -.54, P <.05 an d r = -.56, P <.05, respectively). Conclusion: Plasma fasting homocyst eine concentrations are lowered by E2-dydrogesterone therapy in postme nopausal women. (C) 1998 by The American College of Obstetricians and Gynecologists.