Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on plasma lipids and lipoproteins, coagulation factors, and carbohydrate metabolism

Rogerio A. Lobo, Trudy Bush, Bruce R. Carr, James H. Pickar

Research output: Contribution to journalArticlepeer-review

178 Scopus citations

Abstract

Objective: To determine the effects of lower doses of conjugated equine estrogens (CEE) alone or CEE and medroxyprogesterone acetate (MPA) on lipoproteins, carbohydrate metabolism, and coagulation/fibrinolytic factors. Design: Randomized, double-blind, placebo-controlled study. Setting: Multicenter substudy of the Women's HOPE trial. Patient(s): Seven hundred and forty-nine healthy, postmenopausal women. Intervention(s): Women were randomized to receive the following doses in milligrams per day: 0.625 CEE; 0.625 CEE/2.5 MPA; 0.45 CEE; 0.45 CEE/2.5 MPA; 0.45 CEE/1.5 MPA; 0.3 CEE; 0.3 CEE/1.5 MPA; or placebo. Main Outcome Measure(s): Assessment of lipids, lipoproteins, glucose tolerance, and coagulation/fibrinolytic factors at baseline, cycle 6, and year 1. Result(s): One year of treatment with any of the CEE or CEE/MPA regimens studied increased high-density lipoprotein cholesterol (HDL-C); the 10% increase in HDL-C for the CEE 0.45/MPA 1.5 group was similar to the CEE 0.625/MPA 2.5 group. Low-density lipoprotein cholesterol was significantly reduced in all of the active treatment groups except the CEE 0.3/MPA 1.5 group at cycle 13. Apolipoprotein A-I and triglyceride levels increased and apolipoprotein B levels decreased in all groups. The lipoprotein (a) level was reduced in the CEE 0.45/MPA 2.5, CEE 0.45/MPA 1.5, and CEE 0.625/MPA 2.5 groups. Minimal changes were observed in carbohydrate metabolism for all groups. Fibrinogen and PAI-1 activity decreased and plasminogen activity increased in all groups. Decreases in antithrombin III and protein S activities were significant for all active treatment groups except the CEE 0.3/MPA 1.5 group. Conclusion(s): Lower doses of CEE and CEE/MPA induce favorable changes in lipids, lipoproteins, and hemostatic factors with minimal changes in carbohydrate metabolism.

Original languageEnglish (US)
Pages (from-to)13-24
Number of pages12
JournalFertility and sterility
Volume76
Issue number1
DOIs
StatePublished - Jul 12 2001

Keywords

  • Carbohydrate metabolism
  • Coagulation
  • Conjugated equine estrogens (CEE)
  • Hormone replacement therapy (HRT)
  • Lipids
  • Lipoproteins
  • Lower doses
  • Medroxyprogesterone acetate (MPA)
  • Women's HOPE study

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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