Effects of Continuous and Cyclic Hormone Replacement Therapy on the Lipoprotein Profile in Postmenopausal Women

Abstract

Objective:

To provide an overview of the information concerning cyclic and continuous hormone replacement therapy (HRT) and the effects of the various regimens on the lipid profile.

Data Sources:

MEDLINE (January 1966–December 1996) and Index Medicus (January 1995-December 1996) searches were conducted to identify relevant studies and review articles. Bibliographies of selected articles also were reviewed.

Study Selection:

Studies addressing continuous and cyclic use of a progesterone formulation along with daily conjugated equine estrogen (CEE) and their effects on the lipid profiles of postmenopausal women were selected for review.

Data Extraction:

Applicable data were selected and used in a review format.

Data Synthesis:

CEE has been shown to increase high-density-lipoprotein cholesterol, which may decrease the risk of cardiovascular heart disease. Medroxyprogesterone acetate (MPA) has been added to CEE for postmenopausal HRT to prevent endometrial hyperplasia and cancer. However, MPA negates the beneficial effects of CEE on the lipid profile. Many different HRT regimens, both continuous and cyclic, are being used to increase compliance and to decrease adverse effects. Which regimen offers the best lipid profile results is evaluated in this article.

Conclusions:

The lipid profile effects of HRT using continuous MPA are not significantly different from those obtained with cyclic MPA. Use of a continuous MPA regimen may also offer the long-term advantages of less vaginal bleeding and increased compliance.