The influence of transdermal oestradiol replacement therapy and medroxyprogesterone acetate on serum lipids and lipoproteins

Aims The objective of this study was to examine the effects of continuous transdermal oestradiol with or without sequential oral medroxyprogesterone acetate on serum lipids and lipoproteins in menopausal women. Methods Sixty-two healthy menopausal women, attending at two menopause clinics in Western India, were recruited for this study over a period of 1 year. Group 1 included 38 hysterectomised women being treated with continuous transdermal oestradiol only (50 mu g daily). Group 2 included 24 menopausal women with an intact uterus being treated with transdermal oestradiol (50 mu g daily) and medroxyprogesterone acetate (10 mg daily for the first 12 days of each calendar month). Women maintained on 50 mu g oestradiol throughout 6 months (group 1: n=22; group 2: n=16) were reviewed for changes in serum lipids and lipoproteins at the end of 6 months (group 1), and between days 8 and 12 of the seventh month (combined phase of treatment) (group 2). Results In group 1, there was a small reduction in the concentrations of total cholesterol (-5.5%, P=0.04) and a small but not significant reduction in LDL-cholesterol (-5.7%, P=0.16). In group 2, there were no significant changes in total cholesterol (-4.2%, P=0.43) and LDL-cholesterol (-3.9%, P=0.57). HDL-cholesterol levels did not change significantly with unopposed transdermal oestradiol (+3.0%, P=0.53), or with additional sequential medroxyprogesterone acetate (-3.8%, P=0.32). Serum triglyceride concentrations decreased significantly in both the groups (-13.9%, P=0.01, and -13.4%, P=0.008, respectively). Serum lipid changes did not differ between the groups. Conclusions Transdermal oestrogen therapy appears to be of particular benefit for women with hypertriglyceridaemia. There were no significant adverse effects of medroxyprogesterone acetate on serum lipids and lipoproteins.