Serum lipoprotein changes in climacteric women induced by sequential therapy with natural estrogens and medroxy-progesterone acetate or norgestrel.

Thirty perimenopausal women were randomized to sequential therapy with either estradiol-valerate and norgestrel (Cyclo-Progynon), or estradiol and medroxy-progesterone acetate (EM 627). Blood samples were drawn before treatment and in the third treatment cycle during estrogen and progestogen phases respectively. The clinical effects of the two treatments were without significant difference. Ovulation was not suppressed by the treatments, which induced similar increases in serum estradiol and estrone concentrations. The medium serum high density lipoprotein-(HDL)-cholesterol concentration expressed as a percentage of the pretreatment level decreased in the postmenopausal women treated with Cyclo-Progynon to 90% compared with 104% (p less than 0.01) in the EM 627 group. However, the concentrations expressed in mmol/l did not differ significantly, probably owing to non-significant differences in the pretreatment levels. Low density lipoprotein-(LDL)-cholesterol concentrations decreased by approximately 10% in the postmenopausal women during both treatments. Cyclic addition of medroxy-progesterone acetate to estrogen replacement therapy does not adversely affect the serum lipoprotein pattern, and may be preferable to norgestrel.