The Effects of Oral and Transdermal Estrogen Replacement Therapy on the Levels of Serum Lipids and Lipoproteins in Hysterectomized Postmeonpausal Women

Weon, J C; Cho, S; Jeong, K W; Choi, B; Hwang, S O; Koh, S K; Lee, W Y; Chung, J K

Abstract

Estrogen replacement therapy in postmenopausal women has been known to reduce the risk of cardiovascular disease, and this effect is thought to be mediated in part by favorable changes in serum lipids and lipoproteins. The other cardiovascular protective effects of estrog-ens are vasodilation, anticoagulation and an antiatherosclerosis effects on blood vessels. To elucidate the main effects of estrogen on the levels of serum lipids and lipoproteins, we conducted the randomized trials of oral and transdermal estrogens in healthy hysterectomized postmenopausal women. In this study, the first group(57 patients) received Premarin(conjugated estrogen) 0.625 mg per day. And the second group(53 patients) received transdermal estradiol patches(Estraderm TTS 50) twice weekly. Serum total cholesterol, triglyceride, HDL cholesterol, and LDL cholesterol levels in fasting state were measured in all subjects before treatment and 6 months after treatment. In both groups, serum total cholesterol levels and serum LDL cholesterol levels were decreased significantly after 6 months of treatment. Also, serum HDL cholesterol levels were increased significantly after treatment. Serum triglyceride level was increased in group 1 and decreased in group 2, but there were no statistical significances. The degrees of change were not differ significantly in both groups. These data suggests that the postmenopausal use of estrogens in hysterectomized women, administered by either oral or transdermal route favorably alters serum LDL and HDL levels that may protect women against cardiovascular disease and there are no significant differences statistically between two regimens on the serum lipids and lipoprotein levels. Considering the costs, the side effects and the compliance of patients on the estrogen replacement therapy, oral forms of estrogen are thought to be the first line of therapy in hysterectomized postmenopausal women.