POSTMENOPAUSAL ORAL 17-BETA-ESTRADIOL CONTINUOUSLY COMBINED WITH DYDROGESTERONE REDUCES FASTING SERUM HOMOCYSTEINE LEVELS

Objective: To investigate the effects of oral 17 beta-estradiol admini stration continuously combined with dydrogesterone on fasting serum to tal homocysteine levels in postmenopausal women. Design: Randomized, d ouble-blind study. Setting: Gynecologic outpatient department of a uni versity hospital. Patient(s): One hundred thirty-five healthy, nonhyst erectomized postmenopausal women. Intervention(s): Oral micronized 17 beta-estradiol (2 mg/d) continuously combined with one of four dosages of dydrogesterone (2.5 mg [n = 41], 5 mg [n = 38], 10 mg [n = 37], or 15 mg [n = 19]) was given for 6 months. Main Outcome Measure(s): Fast ing serum total homocysteine concentrations. Result(s): The mean fasti ng serum total homocysteine concentrations in the overall study popula tion decreased significantly (by 13.5%) after the first 3 months of tr eatment and remained unchanged thereafter. No influence of dydrogester one dosage was found. The greatest reduction in total homocysteine con centration was obtained in women with the highest baseline levels. Con clusion(s): Continuously combined hormone replacement therapy lowers f asting serum total homocysteine levels significantly in postmenopausal women. This decrease may be one of the mechanisms that underlie the c ardioprotective effects of postmenopausal hormone replacement therapy. (C) 1998 by American Society for Reproductive Medicine.