Progestogens, lipid metabolism and hormone replacement therapy
Article Abstract:
Women who are at or past the stage of menopause can be treated by replacement of the female hormone estrogen to prevent osteoporosis (loss of bone mass) and reduce the risk of coronary artery disease. The female hormone progestogen is sometimes added to estrogen therapy to protect the endometrium, the inner lining of the uterus, against excessive cell multiplication and development of abnormal growths such as tumors. However, there is concern that progestogen may reduce the protective effects of estrogen against coronary heart disease. Studies have shown that estrogen reduces rates of death and disability due to coronary heart disease by 50 percent or more. Estrogen causes a decrease in the levels of low density lipoproteins (LDL) and an increase in the levels of high density lipoprotein (HDL). These changes protect blood vessels against the development of atherosclerosis, the accumulation of fats and cell overgrowth in blood vessels, which leads to narrowing and obstruction of blood flow. Estrogen also protects against coronary heart disease through other mechanisms, including effects on insulin and glucose metabolism, blood clot formation, blood flow, and the prostaglandin-thromboxane system, which influences blood flow. There is limited information about the effects of progestogen on these other mechanisms. Certain progestogens do not lower HDL levels, and progestogen may actually enhance the effect of estrogen to lower LDL levels. Because progestogen counteracts the tendency of oral estrogens to increase triglycerides, combined hormone replacement may have a beneficial effect. The possibility that progestogens may reduce the protective effect of estrogen against coronary heart disease requires further study. Continued use of combined hormone replacement therapy for postmenopausal women is recommended. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0306-5456
Year: 1991
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A new conjugated estrogen
Article Abstract:
The FDA has approved Cenestin, a synthetic conjugated estrogen. It is derived from soy and yam plants and contains many of the conjugated estrogens in Premarin. It should be used to prevent some of the symptoms of menopause. No clinical trials have been done to evaluate its effectiveness for long-term use. As with other estrogens, it should not be given to women with breast or uterine cancer, vaginal bleeding, thromboembolic disorders, or those who are pregnant.
Publication Name: Medical Letter on Drugs and Therapeutics
Subject: Health
ISSN: 0025-732X
Year: 1999
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