Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974-2000.

Article Details

Citation

Godsland IF

Effects of postmenopausal hormone replacement therapy on lipid, lipoprotein, and apolipoprotein (a) concentrations: analysis of studies published from 1974-2000.

Fertil Steril. 2001 May;75(5):898-915.

PubMed ID
11334901 [ View in PubMed
]
Abstract

OBJECTIVE: To establish reference estimates of the effects of different hormone replacement therapy (HRT) regimens on lipid and lipoprotein levels. DESIGN: Review and pooled analysis of prospective studies published up until the year 2000. SETTING: Clinical trials centers, hospitals, menopause clinics. PATIENT(S): Healthy postmenopausal women. INTERVENTION(S): Estrogen alone, estrogen plus progestogen, tibolone, or raloxifene in the treatment of menopausal symptoms. MAIN OUTCOME MEASURE(S): Serum high- and low-density lipoprotein (HDL and LDL) cholesterol, total cholesterol, triglycerides, and lipoprotein (a). RESULT(S): Two-hundred forty-eight studies provided information on the effects of 42 different HRT regimens. All estrogen alone regimens raised HDL cholesterol and lowered LDL and total cholesterol. Oral estrogens raised triglycerides. Transdermal estradiol 17-beta lowered triglycerides. Progestogens had little effect on estrogen-induced reductions in LDL and total cholesterol. Estrogen-induced increases in HDL and triglycerides were opposed according to type of progestogen, in the order from least to greatest effect: dydrogesterone and medrogestone, progesterone, cyproterone acetate, medroxyprogesterone acetate, transdermal norethindrone acetate, norgestrel, and oral norethindrone acetate. Tibolone decreased HDL cholesterol and triglyceride levels. Raloxifene reduced LDL cholesterol levels. In 41 studies of 20 different formulations, HRT generally lowered lipoprotein (a). CONCLUSION(S): Route of estrogen administration and type of progestogen determined differential effects of HRT on lipid and lipoprotein levels. Future work will focus on the interpretation of the clinical significance of these changes.

DrugBank Data that Cites this Article

Pharmaco-metabolomics
DrugDrug GroupsMetaboliteChangeDescription
MedrogestoneApproved WithdrawnHDL cholesterol
increased
Medrogestone increases the level of HDL cholesterol in the blood
MedrogestoneApproved WithdrawnTriglycerides
increased
Medrogestone increases the level of Triglycerides in the blood
DydrogesteroneApproved Investigational WithdrawnHDL cholesterol
increased
Dydrogesterone increases the level of HDL cholesterol in the blood
DydrogesteroneApproved Investigational WithdrawnTriglycerides
increased
Dydrogesterone increases the level of Triglycerides in the blood
ProgesteroneApproved Vet ApprovedHDL cholesterol
increased
Progesterone increases the level of HDL cholesterol in the blood
ProgesteroneApproved Vet ApprovedTriglycerides
increased
Progesterone increases the level of Triglycerides in the blood
Cyproterone acetateApproved InvestigationalHDL cholesterol
increased
Cyproterone acetate increases the level of HDL cholesterol in the blood
Cyproterone acetateApproved InvestigationalTriglycerides
increased
Cyproterone acetate increases the level of Triglycerides in the blood
Medroxyprogesterone acetateApproved InvestigationalHDL cholesterol
increased
Medroxyprogesterone acetate increases the level of HDL cholesterol in the blood
Medroxyprogesterone acetateApproved InvestigationalTriglycerides
increased
Medroxyprogesterone acetate increases the level of Triglycerides in the blood
NorgestrelApprovedTriglycerides
increased
Norgestrel increases the level of Triglycerides in the blood
NorethisteroneApprovedHDL cholesterol
increased
Norethisterone increases the level of HDL cholesterol in the blood
NorethisteroneApprovedTriglycerides
increased
Norethisterone increases the level of Triglycerides in the blood
TiboloneApproved InvestigationalHDL cholesterol
decreased
Tibolone decreases the level of HDL cholesterol in the blood
NorgestrelApprovedHDL cholesterol
increased
Norgestrel increases the level of HDL cholesterol in the blood
RaloxifeneApproved InvestigationalLDL cholesterol
decreased
Raloxifene decreases the level of LDL cholesterol in the blood
TiboloneApproved InvestigationalTriglycerides
decreased
Tibolone decreases the level of Triglycerides in the blood