Effects of Nonoral Estradiol-micronized Progesterone or Low-dose Oral Estradiol-drospirenone Therapy on Metabolic Variables and Markers of Endothelial Function in Early Postmenopause

Objective: To evaluate the effects of low-dose oral hormone therapy and nonoral hormone therapy on endothelial function markers and on anthropometric, metabolic, and hormonal variables in early postmenopausal women.

Design: Cross-over, randomized clinical trial.

Setting: Gynecological Endocrinology Unit.

Patient(s): Healthy postmenopausal women.

Intervention(s): Twenty patients received oral E(2) 1 mg plus drospirenone 2 mg/d for 2 months. Another group of 20 patients received 3 mg/d 17beta intranasal E(2), and then 200 mg/d vaginal micronized P for 14 days during two 28-day cycles. At the end of this period, the patients were crossed over for another 2 months.

Main Outcome Measure(s): Endothelial function markers and anthropometric, metabolic, and hormonal variables before and after hormone therapy.

Result(s): Mean age was 51.2 +/- 2.7 years. Mean time since menopause was 23.1 +/- 10 months. After low-dose treatment, a reduction in waist circumference, waist-to-hip ratio, and high-density-lipoprotein cholesterol was observed. Triglycerides and von Willebrand factor levels decreased significantly with nonoral treatment. Fasting glucose and insulin levels did not change. In both groups, total and non-high-density-lipoprotein cholesterol levels decreased below basal levels, and endothelin-1, fibrinogen, and C-reactive protein levels remained unchanged.

Conclusion(s): Neither treatment induced deleterious effects in the short term on variables related to cardiovascular risk in early postmenopausal women.