Current status of estrogen therapy for the menopause

Ten years post-menopausal hormone replacement therapy--effect on lipoproteins

Serum lipoproteins were measured in 72 post-menopausal women, 40 of whom had been taking the synthetic oestrogen, mestranol, for a period of 10 yr and 32 of whom had been taking identical placebo tablets. Mestranol therapy was found to increase serum triglycerides, decrease low density lipoprotein (LDL) cholesterol and increase high density lipoprotein (HDL) cholesterol. The increase in HDL cholesterol was due principally to a marked increase in the cardioprotective HDL2 fraction. It is concluded that long-term mestranol therapy has a beneficial effect on serum lipoproteins which may help to protect post-menopausal women against fatal ischaemic heart disease.

Lipoprotein levels during hormone replacement therapy by vaginal ring pessaries

Nineteen women who had had a surgical menopause had a vaginal ring pessary containing levonorgestrel and oestradiol in situ for a period of 3 months. Fasting lipoprotein levels were measured before, and after 1 and 3 months on therapy. After 3 months total triglyceride levels were significantly lower than baseline values (P less than 0.01) as were very-low-density-lipoprotein cholesterol (P less than 0.01), low-density-lipoprotein cholesterol (P less than 0.05) and high-density-lipoprotein cholesterol (P less than 0.001) levels. These changes suggest that in this preparation the effects of the progestogen component are dominant.

Percutaneous oestrogen therapy opposed by lynestrenol or natural progesterone--effects on circulating oestrogens, FSH, sex hormone binding globulin and pregnancy zone protein

Three groups of post-menopausal women were treated with percutaneous 17 beta-oestradiol 3 mg daily opposed by lynestrenol 5 mg or natural micronized progesterone 200 mg and 300 mg, respectively. During 6 mth of cyclic replacement oestrogen serum levels were increased corresponding to follicular phase values. The pre-treatment ratio E1/E2 was unchanged which is in contrast to oral therapy. Progesterone had a much weaker effect on FSH levels than lynestrenol. Women treated with progestogen had regular withdrawal bleedings, while the micronized progesterone was insufficient in this respect. No increase of the oestrogen-sensitive liver proteins, sex hormone binding globulin (SHBG) and pregnancy zone protein (PZP), was recorded in spite of a marked increase in circulating oestrogens.