Comparison of the long-term effects of oral estriol with the effects of conjugated estrogen on serum lipid profile in early menopausal women

Objective: We investigated the long-term effects of oral estriol (E-3) on serum levels of total cholesterol (t-Cho), high-density lipoprotein cholesterol (HDL-Cho), low-density lipoprotein cholesterol (LDL-Cho), and triglycerides in early menopausal women. Methods: We studied 67 healthy early menopausal women who were treated for 48 months with 2.0 mg of E-3 plus 2.5 mg of medroxyprogesterone acetate daily (E-3 group, n = 21), 0.625 mg of conjugated estrogen plus 2.5 mg of medroxyprogesterone acetate daily (CE group, n = 19), or 1.0 mug of 1 alpha -hydroxyvitamin D-3 daily or 1.8 g of calcium lactate containing 250 mg of elemental calcium daily (control group, n = 27). The serum levels of t-Cho, HDL-Cho, LDL-Cho, and triglycerides were evaluated at baseline and every 6 months. Results: After 48 months of treatment, the t-Cho decreased significantly by 4.3 +/- 2.1% (mean +/- SE) from baseline in the E-3 group, did not change in the CE group (- 1.9 +/- 2.1%), and significantly increased (5.4 +/- 3.4%) in the control group. The HDL-Cho significantly increased in the CE group (10.7 +/- 2.4%), but not in the E-3 group (3.8 +/- 3.3%) or in the control group ( - 3.6 +/- 3.0%). The LDL-Cho significantly decreased in the CE group (- 11.4 +/- 4.0%), did not change in the E-3 group (- 5.2 +/- 3.6%), and significantly increased in the control group (11.8 +/- 6.3%). The triglyceride level decreased significantly in the E-3 group (- 6.7 +/- 4.9%), whereas it significantly increased in the CE group (17.6 +/- 11.4%), and did not change in the control group (6.1 +/- 6.4%). Conclusions. Oral E-3 prevented a postmenopausal rise in the t-Cho. Oral estriol did not induce the hypertriglyceridemia that was seen after treatment with conjugated estrogen. Oral E-3 may be a useful alternative therapy in women with hypertriglyceridemia and in women who are reluctant to continue conventional hormone replacement therapy because of uterine bleeding. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.