1 and 2 mg 17[beta]-estradiol combined with sequential dydrogesterone have similar effects on the serum lipid profile of postmenopausal women

The aim of this study was to assess the effects of 1 and 2 mg 17β-estradiol on serum lipid profile. Beneficial effects have been clearly established in previous studies with a 2 mg dose; further evidence was required to confirm the beneficial effects of a 1 mg dose. This double-blind, placebo-controlled study involved 579 postmenopausal women randomized to oral treatment with placebo, 1 mg/day 17β-estradiol sequentially combined with 5 or 10 mg/day dydrogesterone for the last 14 days of each 28-day cycle, or 2 mg/day 17β-estradiol sequentially combined with 10 or 20 mg/day dydrogesterone for the last 14 days of each 28-day cycle. Treatment was continued for 26 cycles. High density lipoprotein (HDL) cholesterol levels were significantly (p < 0.05) increased after 26 cycles in all active treatment groups compared with placebo. In addition, low density lipoprotein (LDL) cholesterol and lipoprotein(a) levels were significantly reduced, and apolipoprotein Al and triglyceride levels were significantly increased, in all active treatment groups after 13 and 26 cycles. The results of this study clearly indicate that sequential combinations of either 1 or 2 mg 17β-estradiol with dydrogesterone are associated with long-term, favorable changes in the serum lipid profile. There was no evidence that dydrogesterone compromised the 17β-estradiol-induced improvements in lipid profile.