The Effects of Daily Continious Estrogen/Progestin Therapy on Lipoproteins and Bone Mineral Density in Menopause

Estrogen replacement is part of the preventive health care of postmenopausal women. The utilization of estrogens for the relief of menopausal complaints, such as atrophic vaginitis and vasomotor symptoms, and the prevention of osteoporosis is well established and may reduce the risk of cononary artery disease.

Despite these benefits, many women are reluctant to use cyclic estrogen/progestin replacement therapy because of the problems of vaginal bleeding and the risk of endometrial cancer.

Furthermore, progestin related side effects such as breast tenderness, headache, nausea, abdominal bloating and depression are additional reasons for patient dissatisfaction, with cyclic therapy.

Continuous regimens of estrogen-progesterone have recently been favored over sequential regimens because of a lower incidence of withdrawal bleeding.

Therefore to determine the effect of different doses of progestin on lipid profiles and bone mineral density, we studied the daily continuous estrogen/progestin therapy in post menopausal vomen during a 1-year prospective trial.

The results were as follows ;

1)The changes of serum cholesterol after hormone therapy in group I,II and III decreased by 1.9%, 6.4%, and 0.2% after one year, but the difference of changes between three groups was not statisitically significant.

2) The changes of serum LDL-cholesterol after hormone therapy in group I,II and III decreased by 22.1%, 19.7%, and 15.5% after one year(p<0.05) but the difference of changes between three groups was not statisitically significant.

3) The changes of serum HLDL-cholesterol after hormone replacement therapy in group I,II and III increased significantly by 16%, 15% and 10% after one year, but the difference of changes between three groups was not statisitically significant.

4) The changes of serum mghecride after hormone replacement therapy in group increased 22%, 6% and decreased about 22% but the difference of changes between three groups was not statisitically significant.

5) The changes of bone mineral density of femur after hormone replacement therapy in three groups was not statisitically significant.

6) The changes of bone mineral density of vertebrae after hormone replacement therapy increased by 2.8%, 1.2%, and 0.2% after one year, but the difference were not statisitically significant.