Aim: To compare the effect on total cholesterol and LDL and HDL cholesterol of oral dydrogesterone and medroxyprogesterone administration combined with continuous transdermal supplementation of 17beta-estradiol in postmenopausal women. MATERIAL & METHODS. The prospective study was carried out in 59 healthy postmenopausal women (mean age 54.5 +/- 3.34 years). They were randomized and treated either with continuous transdermal hormonal therapy (HT) (Group A; n=25; 17beta-estradiol at a dose of 0.05 mg/24 hours combined with oral dydrogesterone at a daily dose of 5 mg or group B, n=24; 17beta-estradiol at a dose of 0.05 mg/24 hours combined with oral medroxyprogesterone at a daily dose of 5 mg) or observed as a control group C (n=10). Basal plasma levels of total cholesterol, HDL-cholesterol and LDL-cholesterol as well as basal estrogen and FSH levels were measured before HT and after 6 and 12 months of treatment. At the same time intervals, all the studied parameters were measured for group C.
Results: After 6 months of continuous transdermal supplementation of 17beta-estradiol with oral dydrogesterone the plasma level of total cholesterol decreased (6.23 +/- 1.02 mmol/l vs 5.65 +/- 0.96 mmol/l; p < 0.05). The effect was also maintained after 12 months of HT (5.46 +/- 1.0 mmol/l). The plasma level of LDL-cholesterol was also decreased after 6 months of HT (3.87 +/- 0.83 mmol/ I vs 3.42 +/- 0.58 mmol/l; p < 0.05). The effect was also maintained after 12 months of HT (3.48 +/- 0.73 mmol/l). HDL-cholesterol plasma level was increased after 6 months of HT (1.52 +/- 0.45 mmol/l vs 1.76 +/- 0.45 mmol/l; p < 0.05) and was maintained after 12 months. The beneficial changes of plasma levels of total cholesterol, HDL-cholesterol and LDL-cholesterol in group B did not reach the statistical significance. The lipid and lipoproteins mean plasma levels remained unchanged in the control group during 12 months of observation.
Conclusion: Adding dydrogestrone or medroxyprogesterone to the continuous transdermal supplementation of 17beta-estradiol did not deteriorate the modificable atherosclerotic risk factors.