Effect of conjugated estrogens with and without medrogestone: a prospective study.

Abstract Objective: To study the possible changes in serum lipids and lipoproteins during hormone replacement therapy with special emphasis on the possible effects brought about by the progestogen. Design: Open-label randomized prospective comparative study. Setting: Gynecological outpatient department of an university hospital. Patients: Thirty-three healthy hysterectomized postmenopausal women. Interventions: Continuous oral supplementation with conjugated estrogens, 0.625 mg daily, was administered either alone (group I; N = 18) or in combination with cyclic medrogestone, 5 mg daily during the last 12 days of each 28 days treatment cycle (group II; N = 15). Main outcome measure: Changes in serum lipids, lipoproteins and apolipoproteins after three, six and 13 treatment cycles. Results: After 1 year of treatment significant increases were observed in mean high-density lipoprotein (HDL) cholesterol, its subfractions, and apolipoprotein A-I in group I and II: HDL cholesterol: +25.2% and +12.1%, respectively; HDL 2 cholesterol: +47.4% and +23.5%, respectively; HDL 3 cholesterol: +18.1% and +11.2%, respectively; apolipoprotein A-I: +23.0 and +14.8%, respectively. Comparing the two study groups no significant differences were found in lipid changes during the study period, except for HDL 2 cholesterol. Conclusion: Supplementation with conjugated estrogens, with and without medrogestone, and given for a longer period, demonstrated a beneficial influence on serum lipoproteins with almost no differences between the two treatment regimens.