Archives of Gynecology and Obstetrics

, Volume 275, Issue 5, pp 335–339 | Cite as

Comparison of two forms of continuous combined hormone replacement therapy with respect to metabolic effects

  • Semih Tugrul
  • Gazi Yildirim
  • Oya Pekin
  • Hüsamettin Uslu
  • Tayfun Kutlu
  • Sadiye Eren
Original Article

Abstract

Objective

To compare the metabolic effects of two frequently used continuous hormone replacement therapies.

Materials and methods

Two hundred and forty-six menopausal women, aged between 41 and 57 years were enrolled in the present study. They were randomized to receive either estrogen + 2.5 mg medroxyprogesterone acetate (CEE/MPA) or 1 mg 17 <beta> estradiol + 0.5 mg norethindrone acetate (E2/NETA). Women in group I (n = 139) and group II (n = 107) were followed up for 1 year and compared with respect to total cholesterol, triglycerides, HDL, LDL, VLDL, weight gain during this period.

Results

The basal and 12th month weight of the patients of two groups were not statistically different (P = 0.57 and P = 0.17, respectively, in the groups I and II). No changes were detected in the levels of triglycerides, HDL and VLDL, while total cholesterol (P = 0.01) and LDL (P = 0.003) levels significantly decreased in the CEE/MPA group. In group 2, total cholesterol and triglyceride levels showed no significant change, however, levels of HDL cholesterol (P = 0.001) increased and LDL (P = 0.001) and VLDL cholesterol (P = 0.006) decreased significantly.

Conclusion

Administration of E2/NETA regimen has better results on lipid profile when compared to CEE/MPA regimen. No weight gain is recorded in E2/NETA group.

Keywords

Medroxyprogesterone acetate Menopause Norethindrone acetate Cholesterol 

References

  1. 1.
    Jorma H, Raija V, Ahomaki SM, Kainulainen P, Vitanen A, Timonen U (2000) Optimizing continuous combined hormone replacement therapy for postmenopausal women: a comparision of six different treatment regimens. Am J Obstet Gynecol 182:560–567CrossRefGoogle Scholar
  2. 2.
    Notelovitz M, Cassel D, Hille D (2000) Efficacy of of continuous sequential transdermal estradiol and norethindrone acetate in relieving vasomotor symptoms associated with menopause. Am J Obstet gynecol 182:7–12PubMedCrossRefGoogle Scholar
  3. 3.
    Cooper A, Whitehead M (1995) Menopause: refining benefits and risk of hormone replacement therapy. Curr Opin Obstet Gynecol 7:214–219PubMedGoogle Scholar
  4. 4.
    Shlipak MG, Simon JA, Vittinghoff E, Lin F, Barrett-Connor E, Knopp RH, Levy RI, Hulley SB (2000) Estrogen and progestin, lipoprotein(a), and the risk of recurrent coronary heart disease events after menopause. JAMA 283(14):1845–1852PubMedCrossRefGoogle Scholar
  5. 5.
    The Writing Group for the PEPI Trial (1995) Effect of hormone replacement therapy on endometrial hystology in postmenopausal women. The postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA 273(3):199–208Google Scholar
  6. 6.
    Christiansen C, Riis BJ (1990) Five years with continuous combined estrogen/progestogen thrapy. Effects on calcium metabolism, lipoproteins and bleeding pattern. Br J Obstet Gynecol 97:1087Google Scholar
  7. 7.
    Hulley S, Grady D, Bush T, Furberg C, Herrington DB, Vittinghoff E, for the Heart and Estrogen/Progestin Replacement Study (HERS) Researche Group (1998) Randomized trial of estrogen plus progestin for secondary prevention of coronary hearth disease in postmenopausal women. JAMA 280:605–613Google Scholar
  8. 8.
    Basta A, Szczudrawa A, Sempka A, Peszek W, Bogdanowicz M (2001) A clinical assessment of a 3 month replacement therapy effectiveness with low norethisterone acetate (Activelle) in postmenopausal women. Przegl Lek 58(6):471–473PubMedGoogle Scholar
  9. 9.
    Johnson JV, Davidson M, Archer D, Bachmann G (2002) Postmenopausal uterine bleeding profiles with two forms of continuous combined hormone replacement therapy. Menopause 9(1):16–22PubMedCrossRefGoogle Scholar
  10. 10.
    Samsioe G, Li C, Borgfeldt C, Wilawan K, Aberg A, Larsen S (2002) Changes in lipid and lipoprotein profile in postmenopausal women receiving low-dose combinations of 17beta-estradiol and norethisterone acetate. Menopause 9(5):335–342PubMedCrossRefGoogle Scholar
  11. 11.
    Manson JE, Hsia J, Johnson KC, Rossouw JE, Assaf AR, Lasser NL, Trevisan M, Black HR, Heckbert SR, Detrano R, Strickland OL, Wong ND, Crouse JR, Stein E, Cushman M, Women’s Health Initiative Investigators (2003) Estrogen plus progestin and the risk of coronary heart disease. N Engl J Med 349(6):523–534Google Scholar
  12. 12.
    Wing R, Matthews K, Kuller L, Meilahn EN, Plantinga PL (1990) Weight gain at the time of menopause. Arch Intern Med 151:97–101CrossRefGoogle Scholar
  13. 13.
    Kritz Silverstein D, Barrett Cannor E (1996) Long term postmenopausal hormone use, obesity and fat distribution in older women. JAMA 27:46CrossRefGoogle Scholar
  14. 14.
    Espeland MA, Stefanick ML, Kritz-Silverstein D, Fineberg SE, Waclawiw MA, James MK, Greendale GA, for the Postmenopausal Estrogen/Progestin Interventions Study Investigators (1997) Effect of postmenopausal hormone therapy on body weight and waist and hip girths. J Clin Endocrinol Metab 82:1549Google Scholar
  15. 15.
    Baerug U, Winge T, Nordland G, Faber-Swensson E, Heldaas K, Norling B, Larsen S, Arce JC (1998) Do combinations of 1 mg estradiol and low doses of NETA effectively control menopausal symptoms? Climacteric 1(3):219–228PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Semih Tugrul
    • 1
    • 2
  • Gazi Yildirim
    • 1
  • Oya Pekin
    • 1
  • Hüsamettin Uslu
    • 1
  • Tayfun Kutlu
    • 1
  • Sadiye Eren
    • 1
  1. 1.Zeynep Kamil Women and Children’s Education and Research HospitalIstanbulTurkey
  2. 2.Bagdat Cad, Bagdat CikmaziIstanbulTurkey

Personalised recommendations