The influence of estrogenic and/or progestogenic treatment on some parameters of lipid metabolism: a controlled clinical study.
This study investigated the effect of estro-progestinic treatment on serum lipid behavior and attempted to clarify the respective roles of each steroid using 74 premenopausal women who had undergone hysterectomy and bilateral adnexectomy and showed no contraindications to estro-progestinic replacement therapy or evidence of dyslipemia. The subjects were randomly divided into 4 groups and given 4 different treatments: 1) estro-progestinic combination (ethinyl estradiol .10 mg, vinylestrenolone 2.5 mg), 2) estrogen (ethinyl estradiol, .10 mg), 3) progestogen (vinylestrenolone, 2.5 mg), and 4) placebo. Subjects were tested before and after the operation for: 1) total serum lipids, 2) total cholesterol, 3) NEFA, 4) TEFA, 5) phospholipids, and 6) beta/alpha lipoprotein level. Women received a 6-cycle supply of pills, identified by a code, upon hospital discharge, and were given the serum lipid battery of tests at the end of cycles 3 and 6. Results are summarized and data are tabulated for variance analysis of the 6 tests. The results showed that estrogen lowered the beta/alpha lipoprotein ratio and an increment of serum phospholipids. The only effect of progestogen was to reduce phospholipids. The combined estrogen-progestogen failed to displace any of the parameters. The absence of a definite pattern of serum lipid behavior is interpreted as resulting from complex interactions between the steroid components.