Lipid effects of hormone replacement therapy with sequential transdermal 17-beta-estradiol and oral dydrogesterone

Objective: To assess the effects on lipid and lipoprotein levels of a combi nation therapy of matrix patch and oral sequential dydrogesterone. Methods: The lipid effects of transdermal estradiol (E2) (80 mu g/day conti nuously) and oral dydrogesterone (10 mg from days 15-28 of each cycle) were assessed in a multicenter, prospective, open, baseline-controlled study. S ubjects were 42 healthy, postmenopausal women who had not had hysterectomie s. Fasting blood samples were taken at baseline, day 14 of cycle 3 (estroge n alone), and day 25 of cycle 6 (estrogen and progestogen). The main outcom e measures were changes from baseline in total cholesterol, high-density li poprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides after six cycles. Results: Thirty-six subjects completed six cycles and in the 28 with comple te data, HDL cholesterol increased by 10.6% from 65.25 to 72.2 mg/dL (95% c onfidence interval [CI] 2.32, 11.58, P = .005) and LDL cholesterol fell by 5.1% from 130.9 to 124.3 mg/dL, (95% CI 13.9, 1.16, P = .07). There was a n onsignificant decrease in LDL cholesterol from 130.9 at baseline to 124.3 m g/dL at 6 months and in triglycerides from 110.6 to 107.1 mg/dL. Conclusion: Sequential treatment with transdermal E2 and oral dydrogesteron e increased HDL cholesterol, without the accompanying increase in triglycer ides that occurs with oral estrogen replacement therapy. (Obstet Gynecol 20 00;95: 111-4. (C) 2000 by The American College of Obstetricians and Gynecol ogists.).