International Digest

Estrogen monotherapy v. combination hormone replacement therapy

Canadian Medical Association Journal 1996; 155: 909-910

Source: Medical Research Council's General Practice Research Framework. Randomised comparison of oestrogen versus oestrogen plus progestogen hormone replacemnt therapy in women with hysterectomy. BMJ 1996; 312: 473-8.

Researchers in England randomly assigned 321 women aged 35 to 39 to receive conjugated estrogen (0.625 µg/d) alone or in combination with norgestrel (0.15 µg/d for the last 12 days of the menstrual cycle) to compare the acceptability and cardioprotective effects of the two hormone replacement regimens. Because of the increased risk of uterine cancer associated with estrogen monotherapy, only women who had undergone hysterectomy were selected. At 2 years there were no significant differences between the groups in side effects, blood pressure or weight changes. At 12 months, factor VIIC activity as well as triglyceride and high-density lipoprotein (HDL) cholesterol concentrations were significantly higher in the estrogen-only group than in the combination-therapy group. A somewhat higher total cholesterol concentration in the estrogen-only group was due to a marked decrease in low-density lipoprotein cholesterol concentrations in both groups coupled with a substantial increase in HDL cholesterol in the estrogen-only group. The researchers concluded that the regimens are comparable with respect to acceptability and overall impact on lipid concentrations and coagulability.

| CMAJ October 1, 1996 (vol 155, no 7) |