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Effects of Hormone Replacement Therapy on Lipids and Lipoproteins in Dyslipidemic Postmenopausal Women: A Comparison Between Transdermal and Oral Estrogen

  • Fiorenza Bruschi
  • Michele Meschia
  • Fabio Amicarelli
  • Monica Rossi
  • Paola Pifarotti
  • PierGiorgio Crosignani
Part of the Medical Science Symposia Series book series (MSSS, volume 11)

Abstract

The physiologic effects of combination hormone replacement therapy are less well established than the effects of estrogen alone. Recently the Postmenopausal Estrogen/ Progestin Interventions (PEPI) Trial [1] offered the most definitive conclusion that estrogen alone or in combination with a progestin decreased low density lipoprotein (LDL) cholesterol and increased high density lipoprotein (HDL) cholesterol. The higher levels of triglycerides, although potentially detrimental, seem to be related to an increased production of large very low density lipoproteins (VLDL), which are less atherogenic than small VLDL. Reports of the metabolic effect of transdermal estrogen are conflicting. Overall, it seems that transdermal estradiol is less effective than oral estrogen on LDL and HDL cholesterol, whereas a fall in triglycerides has been reported [2]. Recently, the National Cholesterol Education Program Adult Treatment Panel II Guidelines suggested hormone replacement therapy an alternative to standard treatments for dyslipidemic postmenopausal women [3].

Keywords

Oral Estrogen Cholesterol Education Program Adult Treatment Education Program Adult Treatment Panel Increase High Density Lipoprotein Cholesterol Combination Hormone Replacement Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    The Writing Group for the PEPI Trial. Effects of estrogen or estrogen/progestin regimens on heart disease risk factors in postmenopausal women: The Postmenopausal Estrogen/Progestin Interventions (PEPI) Trial. JAMA 1995;273:199–208.CrossRefGoogle Scholar
  2. 2.
    Crook D, Cust MP, Gangar KF, et al. Comparison of transdermal and oral estrogen-progestin therapy: Effects on serum lipids and lipoproteins. Am J Obstet Gynecol 1992;166:950–55.PubMedGoogle Scholar
  3. 3.
    The Expert Panel. Summary of the second report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel II). JAMA 1993;269(23):3015–23.CrossRefGoogle Scholar
  4. 4.
    Walsh BW, Sciff I, Rosner B, et al. Effects of postmenopausal estrogen replacement on the concentrations of metabolism of plasma lipoproteins. NEJM 1991;325:1196–204.PubMedCrossRefGoogle Scholar
  5. 5.
    Whitcroft SI, Crook D, Marsh MS, et al. Long-term effects of oral and transdermal hormone replacement therapies on serum lipid and lipoprotein concentrations. Obstet Gynecol 1994;84:222–26.PubMedGoogle Scholar
  6. 6.
    Newnham HH. Oestrogens and atherosclerotic vascular disease-lipid factors. Baillieres Clin Endocrinol Metab 1993;7:61–93.PubMedCrossRefGoogle Scholar
  7. 7.
    Tikkanen Mj, Kuusi T, Vartiainen E, Nikkila EA. Treatment of post-menopausal hypercholesterolemia with estradiol. Acta Obstet Gynecol Scand Suppl 1979;88:83–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Denke MA. Effects of continuous combined hormone-replacement therapy on lipid levels in hypercholesterolemic postmenopausal women. Am J Med 1995;99:29–35PubMedCrossRefGoogle Scholar
  9. 9.
    Jacobs DR, Mebane IL, Bangdiwala SI, Criqui MH, Tyroler HA. High density lipoprotein cholesterol as a predictor of cardiovascular disease mortality in men and women: The follow-up study of the Lipid Research Clinics Prevalence Study. Am J Epidemiol 1990;131:32–47.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1997

Authors and Affiliations

  • Fiorenza Bruschi
  • Michele Meschia
  • Fabio Amicarelli
  • Monica Rossi
  • Paola Pifarotti
  • PierGiorgio Crosignani

There are no affiliations available

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