METABOLIC EFFECT OF 2 HORMONAL PREPARATIONS IN POSTMENOPAUSAL WOMEN

Objectives: To compare the metabolic and endocrinological effects of e stradiol valerate/cyproterone acetate (EV/CPA) to a regimen of conjuga ted estrogens/medroxyprogesterone acetate (CE/MPA) in postmenopausal w omen. Methods: Lipid profile, endocrinological parameters, coagulation factors, renin and angiotensinogen were followed in postmenopausal wo men randomized to EV/CPA or CE/MPA during 12 cycles. Results: Followin g 12 cycles of treatment, total plasma cholesterol decreased more with EV/CPA than with CE/MPA. Low-density cholesterol decreased with EV/CP A while it increased with CE/MPA. High-density cholesterol remained fa irly unchanged, and triglycerides increased significantly in both grou ps. Estradiol and estrone levels increased significantly more with EV/ CPA than with CE/MPA while the sex-hormone-binding globulin increased more with CE/MPA. Follicle stimulating and luteinizing hormone levels also decreased significantly. Total testosterone and dihydroepiandrost erone sulfate remained stable. Total levothyroxine serum levels increa sed significantly, but thyroid stimulating hormone and triiodothyronin e levels remained stable. Coagulation parameters also remained stable. Angiotensinogen increased, while plasma renin activity and blood pres sure remained unchanged. Conclusion: It is concluded that both EV/CPA and CE/MPA produce favourable metabolic effects. A better lipid profil e, compatible with decreased cardiovascular risk, is observed with the EV/CPA regimen. Higher circulating estrogen levels may explain in par t this observation. (C) 1997 Elsevier Science Ireland Ltd.