Menopause and hyperlipidemia: pravastatin lowers lipid levels without decreasing endogenous estrogens

In study 1, serum lipid and estrogen levels were determined in 30 women (aged 40 to > 60 years). Total cholesterol (TC) levels increased significantly with age, but no significant association was found between TC levels and menopausal status. Hypercholesterolemia (TC > 220 mg/dl) was identified in 10 women and hypertriglyceridemia (> 150 mg/dl) in 5 women. Among women not receiving estrogen replacement therapy, a significant negative correlation was found between TC levels and estradiol-17 beta levels. In study 2, serum lipid and estrogen levels were determined in 74 women; 12 of the 74 were receiving conjugated estrogen for the treatment of the menopausal syndrome and 21 hyperlipidemic women were receiving pravastatin (2.5 to 30 mg daily). Among postmenopausal women, high-density lipoprotein cholesterol levels were significantly higher and low-density lipoprotein (LDL) cholesterol levels significantly lower in the estrogen-treated than untreated women. Serum TC and LDL cholesterol levels were significantly reduced during pravastatin treatment. Levels of endogenous estrogens (estradiol-17 beta, estrone, and estrone sulfate) were not significantly affected by pravastatin treatment. The results indicate that pravastatin can be used to reduce hyperlipidemia in menopausal women without affecting endogenous estrogen levels.