Safety of hormone replacement therapy in menopause and its favorable effect on the lipid spectrum

: The authors pay attention to changes of the serum lipid spectrum and blood sugar level during hormonal substitution treatment of menopausal women. The observation pertains to 70 women (mean age 50 years, 36 women after hysterectomy, mean duration of the menopause 4.5-5.0 years). The lipid spectrum and blood sugar level were assessed by enzyme methods from venous blood collected in the morning on fasting before administration of treatment (a combination of oestrogen and gestagen), on average after 8 months on these drugs. With regard to total cholesterol and HDL-cholesterol before treatment the women were, consistent with recommendations of the European Society for Atherosclerosis divided into four groups: hypercholesterolaemic group (5.2-7.8 mmol/l) 47 women; hypercholesterolaemic group with a reduced HDL-cholesterol (less than 1.1 mmol/l) 5 women; a very high cholesterol group (more than 7.8 mmol/l) one woman only; and women with a normal lipid profile (total cholesterol less than 5.2 mmol/l), 17 women. The authors recorded in the whole group a significant drop of total cholesterol (-0.30 mmol/l), VLDL-cholesterol (-0.08 mmol/l) and triacylglycerols (-0.27 mmol/l) and a significant rise of HDL-cholesterol (+0.13 mmol/l). The blood sugar level did not change. There was an insignificant drop of LDL-cholesterol. Hepatic serum enzymes did not change during this treatment. The most marked changes (a drop of LDL-cholesterol by 0.49 mmol/l and rise of HDL-cholesterol by 0.29 mmol/l) were recorded in the group with the highest risk, i.e. group 2. The total drop of triacylglycerols was striking. The body weight and dietary habits did not change during the mentioned 8-month period. The authors consider hormonal replacement therapy indicated. They emphasize its favourable effect on the lipid spectrum of women which is one of the mechanisms of cardiovascular oestrogen protection.