Transdermally administered oestradiol combined with oral medroxyprogesterone acetate: the effects on lipoprotein metabolism in postmenopausal women

Abstract
To investigate the effects of two doses of transdermally applied oestradiol on lipid and lipoprotein metabolism in climacteric women. A randomised double blind cross-over comparison. Departments of Obstetrics and Gynaecology, Ostra and Sahlgren's Hospital, Göteborg and Karolinska Hospital, Stockholm, Sweden. Fifty-two women with climacteric symptoms were treated with oestradiol transdermally applied (50 micrograms and 100 micrograms/24 h). A daily dose of 5 mg oral medroxyprogesterone acetate was added 14 days each treatment cycle of four weeks. Blood samples were drawn after an overnight fast before and after four and eight months of treatment. Assays for serum triglycerides and cholesterol as well as low density lipoprotein (LDL) and high density lipoprotein (HDL) cholesterol including the subfractions HDL2 and HDL3 were performed. Significant decrements were found in triglycerides and serum and LDL cholesterol during treatment with both doses. A modest rise in HDL2 cholesterol was observed after treatment with the 100 micrograms/24 h dose. The serum lipid and lipoprotein profile encountered in these women was similar to that reported with oral formulations except for a decrease in triglycerides. The metabolic differences between the two doses of transdermal oestradiol is probably of minor clinical significance in normal postmenopausal women.