Cardiovascular risk factors and combined estrogen-progestin replacement therapy: a placebo-controlled study with nomegestrol acetate and estradiol

• Published in: Fertility and sterility Vol. 64; no. 5; pp. 957 - 962
• Main Authors: Conard, Jacqueline, Basdevant, Arnaud, Thomas, Jean-Louis, Ochsenbein, Edith, Denis, Catherine, Guyene, Than Tam, Degrelle, Hervé
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.1995; Elsevier Science
• Subjects: Apoproteins - blood; Biological and medical sciences; Blood Glucose - analysis; Blood Pressure - drug effects; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - physiopathology; Cholesterol - blood; coagulation; Double-Blind Method; Drug Combinations; Estradiol; Estradiol - pharmacology; Estrogen Replacement Therapy - standards; Female; Fibrinogen - analysis; Follicle Stimulating Hormone - blood; Genital system. Reproduction; hormone replacement therapy; Humans; lipoprotein(a); lipoproteins; Lipoproteins - blood; Medical sciences; Megestrol; menopause; Middle Aged; nomegestrol acetate; Norpregnadienes - pharmacology; Pharmacology. Drug treatments; Plasminogen - analysis; Progesterone Congeners - pharmacology; progestins; Prospective Studies; Renin - blood; Risk Factors; Triglycerides - blood; progestins; menopause; nomegestrol acetate; hormone replacement therapy; Estradiol; lipoprotein(a); coagulation; lipoproteins; Human; Replacement therapy; Toxicity; Menopause; Estrogen; Coagulation; 17β-Estradiol; Cardiovascular disease; Lipids; Risk analysis; Coronary heart disease; Ovarian hormone; Progestagen; Chemotherapy; Lipemia; Estroprogestagen; Postmenopause; Female; Progesterone; Sex steroid hormone
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(16)57909-6

To assess the effects of oral E2 replacement therapy combined with nomegestrol acetate, a 19-norprogesterone derivative, on cardiovascular risk factors. A double-blind randomized prospective study comparing the effect of a placebo and two oral E2-nomegestrol acetate combinations (1mg-2.5mg and 1.5mg-3.75mg) over a three-cycle trial. Department of Internal Medicine and Nutrition, Hotel-Dieu, Paris, France. Fifty-seven nonhysterectomized women with natural menopause. Blood pressure, renin substrate, glucose, total cholesterol, high-density and low-density lipoprotein cholesterol, triglycerides, apoproteins A1 and B, lipoprotein(a), antithrombin III, fibrinogen, plasminogen, prothrombin fragment 1+2, protein C, and total and free protein S. Both treatments significantly reduced menopausal complaints, total cholesterol, low-density lipoprotein cholesterol and lipoprotein(a). Treatment with the 1.5mg-3.75mg combination resulted in a significant increase in apolipoprotein A1. No significant change were observed in other parameters. Sequentially combined with oral E2 in hormone replacement therapy, nomegestrol acetate had favorable effects on plasma lipids and lipoproteins. This nonandrogenic progestin decreased lipoprotein(a) levels as observed previously with medroxyprogesterone acetate combined with conjugated equine estrogens.