Comparison of the long-term effects of oral estriol with the effects of conjugated estrogen on serum lipid profile in early menopausal women

Objective: We investigated the long-term effects of oral estriol (E-3) on s erum levels of total cholesterol (t-Cho), high-density lipoprotein choleste rol (HDL-Cho), low-density lipoprotein cholesterol (LDL-Cho), and triglycer ides in early menopausal women. Methods: We studied 67 healthy early menopa usal women who were treated for 48 months with 2.0 mg of E-3 plus 2.5 mg of medroxyprogesterone acetate daily (E-3 group, n = 21), 0.625 mg of conjuga ted estrogen plus 2.5 mg of medroxyprogesterone acetate daily (CE group, n = 19), or 1.0 mug of 1 alpha -hydroxyvitamin D-3 daily or 1.8 g of calcium lactate containing 250 mg of elemental calcium daily (control group, n = 27 ). The serum levels of t-Cho, HDL-Cho, LDL-Cho, and triglycerides were eval uated at baseline and every 6 months. Results: After 48 months of treatment , the t-Cho decreased significantly by 4.3 +/- 2.1% (mean +/- SE) from base line in the E-3 group, did not change in the CE group (- 1.9 +/- 2.1%), and significantly increased (5.4 +/- 3.4%) in the control group. The HDL-Cho s ignificantly increased in the CE group (10.7 +/- 2.4%), but not in the E-3 group (3.8 +/- 3.3%) or in the control group ( - 3.6 +/- 3.0%). The LDL-Cho significantly decreased in the CE group (- 11.4 +/- 4.0%), did not change in the E-3 group (- 5.2 +/- 3.6%), and significantly increased in the contr ol group (11.8 +/- 6.3%). The triglyceride level decreased significantly in the E-3 group (- 6.7 +/- 4.9%), whereas it significantly increased in the CE group (17.6 +/- 11.4%), and did not change in the control group (6.1 +/- 6.4%). Conclusions. Oral E-3 prevented a postmenopausal rise in the t-Cho. Oral estriol did not induce the hypertriglyceridemia that was seen after t reatment with conjugated estrogen. Oral E-3 may be a useful alternative the rapy in women with hypertriglyceridemia and in women who are reluctant to c ontinue conventional hormone replacement therapy because of uterine bleedin g. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.