Effects of Continuous Combined Estrogen-Progestin Treatment on Serum Lipid and Lipoprotein Levels in Postmenopausal Women

Choi, Y M; Lee, K S; Park, S Y; Lee, B H; Choi, J; Suh, C S; Kim, S H; Shin, C J; Kim, J K; Moon, S Y; Chang, Y S; Lee, J Y

Abstract

In estrogen replacement therapy for postmenopausal women, progestins used to oppose neoplastic effects of estrogen on endometrium may negate the beneficial effects on serum lipoprotein profiles. Two hundred and eighty five postmenopausal women were recruited to evaluate the impact on serum lipid profiles of continuous combined estrogen-progestin (CCEP) replacement therapy. All women received conjugated equine estrogen (CEE, 0.625 mg Premarin) for days 1-31; with group I (49 patients) receiving 2.5 mg medroxyprogesterone acetate (MPA) for days 1-31, group II (109 patients) receiving 10 mg MPA for days 1-12, and group III (127 patients) receiving only CEE. Total duration of the study was 12 cycles (12 months). In group I, a significant increase in serum HDL cholesterol level was observed after 9 months of treatment with a significant decrease in serum LDL cholesterol level at 3 months and no significant change in serum triglyceride level. Continuous combined regimen blunted the increase in serum HDL cholesterol and triglyceride levels induced by CEE only, but it was not significant. Compared with sequential regimen of progestin, CCEP showed a little increase in HDL cholesterol, but a comparable decrease in LDL cholesterol. These data suggest that continuous combined regimen of Premarin (0.625 mg daily) and MPA (2.5 mg daily) induces a beneficial change in serum lipoprotein levels, with a little blunted increase in HDL cholesterol compared with unopposed estrogen.