Effects of sex steroid hormones on lipoprotein levels in pre- and post menopausal women

Abstract

Women are affected by disorders of lipid metabolism in the same way as men. Sex steroids given as oral contraceptives at all doses have clearcut, formulation-specific effects on lipoprotein levels in reproductive-aged women. In estrogen-dominant versus androgenic progestin-dominant formulations, LDL cholesterol levels were unchanged and significantly increased, respectively, and HDL cholesterol was increased and decreased, respectively. The greatest HDL lowering is seen with the most androgenic formulations. Major increases in LDL cholesterol confer risk for cardiovascular disease on this group, so caution is recommended in formulation selection. In general, cardiovascular disease risk in post menopausal women using estrogen is reduced 30 to 70%. Concurrent administration of progestin with post menopausal estrogen appears to reduce the beneficial rise in HDL associated with estrogen administration alone. Cardiovascular disease is likely to be reduced by estrogen in post menopausal women.