We evaluated the effect of transdermal norethisterone acetate (NETA) versus oral medroxyprogesterone acetate (MPA) on the lipids of 28 postmenopausal women taking hormonal replacement therapy for climacteric symptoms. All the 28 patients were using conventional patches releasing 0.050 mg of estradiol per day continuously. However, while one group of 14 patients received transdermal NETA (0.25 mg/day) for 14 days of the cycle, the other group of 14 patients received oral MPA (10 mg/day) for the same number of days. The patients were randomly allocated to one of the two groups. The treatment cycles were repeated for 12 months. There was no significant difference between the two treatment groups for compliance and for incidence of side effects. Both hormonal replacement therapies were equally effective in relieving climacteric symptoms. All the patients underwent serum lipid assays twice, the first time before starting treatment and then again during the progestogen phase of the 12th and last cycle. Serum total cholesterol (TC), low-density lipoprotein (LDL-C), and triglyceride levels did not change significantly during both treatments. Transdermal estradiol associated with oral MPA significantly reduced high-density lipoprotein (HDL-C) by 17.9% (p < 0.05) and significantly increased LDL-C/HDL-C and TC/HDL-C risk ratios by 61.7% (p < 0.05) and 33.1% (p < 0.05), respectively. In contrast, administration of the transdermal NETA did not significantly affect HDL-C levels (- 1.9% of decrease) and, consequently, the risk ratios were minimally altered, with 3.3 and 6.0% increases for TC/HDL-C and LDL-C/HDL-C, respectively. There was a statistically significant difference (p < 0.05) in HDL-C net changes between MPA and NETA treatments (+ 8.5 and - 8.0 mg/dl, respectively). We can therefore conclude that the association of transdermal NETA with transdermal estradiol elicits a relatively benign impact on lipoprotein profile in comparison to oral MPA association
Hormonal Replacement Therapy and Lipids: Is Transdermal Norethisterone Acetate Better Than Oral Medroxyprogesterone Acetate?
PANSINI, Francesco Saverio;BONACCORSI, Gloria;ZANOTTI, Laura;VIGNA, Giovanni Battista;MOLLICA, Gioacchino
1995
Abstract
We evaluated the effect of transdermal norethisterone acetate (NETA) versus oral medroxyprogesterone acetate (MPA) on the lipids of 28 postmenopausal women taking hormonal replacement therapy for climacteric symptoms. All the 28 patients were using conventional patches releasing 0.050 mg of estradiol per day continuously. However, while one group of 14 patients received transdermal NETA (0.25 mg/day) for 14 days of the cycle, the other group of 14 patients received oral MPA (10 mg/day) for the same number of days. The patients were randomly allocated to one of the two groups. The treatment cycles were repeated for 12 months. There was no significant difference between the two treatment groups for compliance and for incidence of side effects. Both hormonal replacement therapies were equally effective in relieving climacteric symptoms. All the patients underwent serum lipid assays twice, the first time before starting treatment and then again during the progestogen phase of the 12th and last cycle. Serum total cholesterol (TC), low-density lipoprotein (LDL-C), and triglyceride levels did not change significantly during both treatments. Transdermal estradiol associated with oral MPA significantly reduced high-density lipoprotein (HDL-C) by 17.9% (p < 0.05) and significantly increased LDL-C/HDL-C and TC/HDL-C risk ratios by 61.7% (p < 0.05) and 33.1% (p < 0.05), respectively. In contrast, administration of the transdermal NETA did not significantly affect HDL-C levels (- 1.9% of decrease) and, consequently, the risk ratios were minimally altered, with 3.3 and 6.0% increases for TC/HDL-C and LDL-C/HDL-C, respectively. There was a statistically significant difference (p < 0.05) in HDL-C net changes between MPA and NETA treatments (+ 8.5 and - 8.0 mg/dl, respectively). We can therefore conclude that the association of transdermal NETA with transdermal estradiol elicits a relatively benign impact on lipoprotein profile in comparison to oral MPA associationI documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
