METABOLIC AND HORMONAL EFFECTS OF POST-MENOPAUSAL OESTROGEN REPLACEMENT TREATMENT

Abstract

ABSTRACT The influence of daily oral cyclical oestrogen treatment on the plasma lipid and lipoprotein concentrations was studied in post-menopausal females. Ethinyloestradiol (EOe) 0.05 mg was administered to 20 subjects and oestradiol valerianate (OeV) 2 mg to 19 subjects. The women were investigated twice before medication and 1, 3 and 6 months after the start of treatment. During EOe therapy the total cholesterol (TC) decreased 10 per cent, high density lipoprotein (HDL)-TC and HDL-phospholipid (PL) increased 30–40 per cent, approximated low density lipoprotein (LDL)-TC decreased 30 per cent and triglyceride (TG) increased 30–40 per cent. In the OeV treated group the HDL-TC and the HDL-PL concentrations showed a mean increase of 10–15 per cent after 6 cycles. Augmented HDL-TC level and/or decreased LDL-TC level is believed to reduce the risk for the development of atherosclerotic disease. Increased TG concentration probably raises the risk for ischaemic cardiovascular disease. Thus the net effect on the development of ischaemic cardiovascular disease due to the changes of plasma lipids induced by EOe 0.05 mg can at present not be evaluated while the plasma lipid changes observed during OeV 2 mg might hypothetically retard the development of atherosclerosis. Only 10 per cent of the changes of lipid and lipoprotein concentrations could be explained statistically by their correlations to the simultaneously occurring alterations in the glucose tolerance and the concentrations of insulin and growth hormone. The dissimilar changes in the lipid parameters in the EOe and OeV groups might be explained by the different oestrogenic potency of the drugs and a dose-response relationship of oestrogen treatment on protein and probably lipoprotein synthesis.