Effects of post-menopausal oestrogen-progestogen replacement therapy on serum lipids and lipoproteins: a review

There are strong indications that post-menopausal oestrogen replacement therapy has a protective effect on the cardiovascular system, due to changes in the lipid profile. There are also indications that the addition of progestogens to oestrogen therapy may negatively influence these effects on the lipid metabolism. The present survey was undertaken to provide a comprehensive summary of all the available data on the effect of combined oestrogen-progestogen treatment on the post-menopausal lipid profile published from 1984 onwards. It appears that many progestogens are capable of diminishing the beneficial changes induced by oestrogens. The ultimate effect depends on the type and daily dose of both the oestrogen and the progestogen component. Oestradiol or oestradiol valerate administered cyclically with progesterone or cyproterone acetate appear to have the most favourable impact on lipids and lipoproteins.