Comparison of two forms of continuous combined hormone replacement therapy with respect to metabolic effects
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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 CholesterolReferences
- 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.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.Cooper A, Whitehead M (1995) Menopause: refining benefits and risk of hormone replacement therapy. Curr Opin Obstet Gynecol 7:214–219PubMedGoogle Scholar
- 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.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.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.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.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.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.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.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.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.Kritz Silverstein D, Barrett Cannor E (1996) Long term postmenopausal hormone use, obesity and fat distribution in older women. JAMA 27:46CrossRefGoogle Scholar
- 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.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