Metabolic and hormonal parameters in post-menopausal women 10 years after transdermal oestradiol treatment, alone or combined to micronised oral progesterone

Abstract

Background. In the post-Women's Health Initiative Study era few post-menopausal women complete long term hormonal treatment (HT). Objective. To analyse metabolic/hormonal parameters and frequency of the metabolic syndrome (METS) in post-menopausal women after 10 years of HT. Methods. Retrospective data from parallel cohorts of post-menopausal women receiving HT for 10 years was analysed. Regimens included: transdermal oestradiol (50 μg) (n = 22), sequential cyclic HT with transdermal oestradiol (50 μg) plus 200 mg/day micronised oral progesterone (cycle days 12–25) (n = 83), or continuous combined HT with transdermal oestradiol (50 μg) plus 100 mg/day micronised oral progesterone (n = 46). A group of women who elected not to use HT served as a control group (n = 35). Results. Frequency of the METS did not significantly increase after 10 years of HT. Oestradiol and sex hormone binding globulin (SHBG) levels displayed a significant increase compared to baseline after 10 years of HT (all regimens). These values were significant higher when compared to the control group. Glucose levels were significantly higher after 10 years in women receiving the sequential cyclic regimen. Although not reaching statistical significance, there was a trend for transdermal oestradiol alone to increase HDL-C and decrease triglyceride levels. Conclusion. Serum oestradiol and SHBG levels were significantly higher after 10 years of transdermal oestradiol, alone or combined with micronised oral progesterone, without differences observed in serum metabolic parameters. More research through randomised clinical trials is required.