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Serum lipoprotein effects of conjugated estrogen and a sequential conjugated estrogen-medrogestone regimen in hysterectomized postmenopausal women

  • Ernst W.W. Sonnendecker
    Correspondence
    Reprint requests: Professor E. W. W. Sonnendecker, Chairman, Department of Obstetrics and Gynecology, University of the Witwatersrand, Medical School, 7 York Road, Parktown, Johannesburg, 2193 South Africa.
    Affiliations
    Department of Obstetrics and Gynecology, University of the Witwatersrand, Johannesburg, and the Research Institute, for Nutritional Disease of the South African Medical Research Council, Johannesburg, South Africa
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  • Everard S. Polakow
    Affiliations
    Department of Obstetrics and Gynecology, University of the Witwatersrand, Johannesburg, and the Research Institute, for Nutritional Disease of the South African Medical Research Council, Johannesburg, South Africa
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  • A.J. Spinnler Benade
    Affiliations
    Department of Obstetrics and Gynecology, University of the Witwatersrand, Johannesburg, and the Research Institute, for Nutritional Disease of the South African Medical Research Council, Johannesburg, South Africa
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  • Estelle Simchowitz
    Affiliations
    Department of Obstetrics and Gynecology, University of the Witwatersrand, Johannesburg, and the Research Institute, for Nutritional Disease of the South African Medical Research Council, Johannesburg, South Africa
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      Abstract

      The progestogen chosen for addition to estrogen replacement is important because some progestins adversely influence the effects of oral estrogens on lipid metabolism. In this double-blind study, 22 estrogen-deficient hysterectomized women were treated initially for six cycles with either 0.625 mg conjugated equine estrogens for 21 days plus a placebo during the last 10 days of each cycle or the same estrogen regimen with 10 days of 5 mg medrogestone per day. Thereafter, the treatments were crossed over for a further six cycles. Levels of lipids, lipoproteins, and apolipoproteins were determined at baseline and the last day of sixth and twelfth treatment cycles. Conjugated equine estrogen monotherapy resulted in significantly increased levels of high-density lipoprotein cholesterol (p < 0.01); percent high-density lipoprotein cholesterol (p < 0.001), and high-density lipoprotein, cholesterol (p < 0.001), with significantly decreased total cholesterol (p < 0.01), low density lipoprotein cholesterol, and atherogenic index (p < 0.001). Medrogestone caused no attenuation of any of these clinically important lipoprotein changes. Therefore from the lipoprotein aspect medrogestone is a desirable progestogen. (Ann J OBSTET GYNECOL 1989;160:1128-34.)

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