METABOLIC AND HORMONAL EFFECTS OF POST-MENOPAUSAL OESTROGEN REPLACEMENT TREATMENT

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Abstract
The influence of daily oral cyclical estrogen treatment on the plasma lipid and lipoprotein concentrations was studied in post-menopausal females. Ethinylestradiol (EOe) 0.05 mg was administered to 20 subjects and estradiol valerianate (OeV) 2 mg to 19 subjects. The women were investigated twice before medication and 1, 3 and 6 mo. after the start of treatment. During EOe therapy the total cholesterol (TC) decreased 10%, high density lipoprotein (HDL)-TC and HDL-phospholipid (PL) increased 30-40%, approximated low density lipoprotein (LDL)-TC decreased 30% and triglyceride (TG) increased 30-40. In the OeV treated group the HDL-TC and the HDL-PL concentrations showed a mean increase of 10-15% 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 ischemic cardiovascular disease. Thus the net effect on the development of ischemic 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% of the changes of lipid and lipoprotein concentrations could be explained statistically by their correlations to the stimultaneously 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 estrogenic potency of the drugs and a dose-response relationship of estrogen treatment on protein and probably lipoprotein synthesis.