The Effects of Oral Desogestrel and Estradiol Continuous Combined Hormone Replacement Therapy on Serum Lipids and Body Composition in Postmenopausal Women

Abstract

Several studies have demonstrated a relationship between body fat distribution and risk of cardiovascular disease, but the reasons for such an association are unknown. Estrogen hormone replacement therapy (HRT) is known to reduce the risk of cardiovascular disease. This is partly due to its action to lower low density lipoprotein (LDL) and raise high density lipoprotein (HDL), effects which may be antagonized by progestogen addition. The addition of progestogens in HRT in non-hysterectomized women is necessary to prevent the endometrial hyperplasia and carcinoma that develops with unopposed estrogen use. Traditionally progestogens are given cyclically and induce a withdrawal bleed. However, continuous progestogen administration may avoid this unwanted side effect. Desogestrel is a c-19 progestogen that is derived from levonorgestrel which may have less androgenic effects than the parent molecule. The relationships between the effects of HRT on lipoproteins and body composition have not yet been established.