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Review
. 2025 Apr 1;17(1):111.
doi: 10.1186/s13098-025-01664-1.

The effects of transdermal estrogens combined with Medroxyprogesterone Acetate on cardiovascular disease risk factors in postmenopausal women: a meta-analysis of randomized controlled trials

Fan Zhou  1 , Kousalya Prabahar  2 , Jiao Shu  3
Affiliations
Review

The effects of transdermal estrogens combined with Medroxyprogesterone Acetate on cardiovascular disease risk factors in postmenopausal women: a meta-analysis of randomized controlled trials

Fan Zhou et al. Diabetol Metab Syndr. .

Abstract

Background: To date, no meta-analysis has reported on the role of transdermal estrogens combined with Medroxyprogesterone Acetate (MPA) in relation to cardiovascular disease (CVD) risk factors in postmenopausal women. To fill this knowledge gap, a meta-analysis of randomized controlled trials (RCTs) was conducted to assess the effects of transdermal estrogens and MPA on CVD risk factors in postmenopausal women.

Methods: A systematic literature search was conducted in major databases including PubMed/Medline, Web of Science, SCOPUS, and Embase, from inception to 12 February 2025. The combination of Medical Subject Headings (MeSH) and non-MeSH keywords was used.

Results: A total of 14 trials were included in the meta-analysis. The combined eligible trials found that transdermal estrogens combined with MPA significantly decreased total cholesterol (TC) (WMD: -13.37 mg/dL, 95% CI: -21.54 to -5.21, p = 0.001), low density lipoprotein cholesterol (LDL-C) (WMD: -12.17 mg/dL, 95% CI: -23.26 to -1.08, p = 0.031), and apolipoprotein B (ApoB) (WMD: -7.26 mg/dL, 95% CI: -11.48 to -3.03, p = 0.001) compared to the control. No statistically significant associations were observed between transdermal estrogens combined with MPA on triglyceride (TG), high density lipoprotein cholesterol (HDL-C), lipoprotein(a) (Lp(a)), and apolipoprotein A1 (ApoAI).

Conclusion: Based on the results of the current meta-analysis, transdermal estrogens combined with oral MPA administration had a beneficial effect on certain CVD risk factors in postmenopausal women, as evidenced by the significant reductions in TC, LDL-C, and ApoB.

Keywords: Apolipoproteins; Cholesterol; Lipid profile; Lipoprotein(a); Postmenopausal women; Transdermal estrogens combined with oral Medroxyprogesterone acetate; Triglycerides.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart for study examined and included into the meta-analysis
Fig. 2
Fig. 2
Forest plot of the randomized controlled trials investigating the effects of transdermal Estrogens combined with Oral Medroxyprogesterone Acetate administration on TG
Fig. 3
Fig. 3
Forest plot of the randomized controlled trials investigating the effects of transdermal transdermal Estrogens combined with Medroxyprogesterone Acetate administration on TC
Fig. 4
Fig. 4
Forest plot of the randomized controlled trials investigating the effects of transdermal Estrogens combined with Oral Medroxyprogesterone Acetate administration on LDL-C
Fig. 5
Fig. 5
Forest plot of the randomized controlled trials investigating the effects of transdermal Estrogens combined with Medroxyprogesterone Acetate administration on HDL-C
Fig. 6
Fig. 6
Funnel plot of the weighted mean difference (WMD) versus the standard error (s.e.) of the WMD
See this image and copyright information in PMC

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References

    1. Lindstrom M, DeCleene N, Dorsey H, Fuster V, Johnson CO, LeGrand KE, et al. Global burden of cardiovascular diseases and risks collaboration, 1990–2021. J Am Coll Cardiol. 2022;80(25):2372–425. - PubMed
    1. Torfi E, Bahreiny SS, Saki N, Khademi R, Sarbazjoda E, Nezhad IA, et al. Evaluation of Pro-BNP biomarker in heart failure patients and its relationship with complete blood count parameters: A case–control study. Health Sci Rep. 2024;7(9):e70083. - PMC - PubMed
    1. Kamińska MS, Schneider-Matyka D, Rachubińska K, Panczyk M, Grochans E, Cybulska AM. Menopause predisposes women to increased risk of cardiovascular disease. J Clin Med. 2023;12(22):7058. - PMC - PubMed
    1. Rethemiotaki I. Global prevalence of cardiovascular diseases by gender and age during 2010–2019. Arch Med Sci Atheroscler Dis. 2023;8:e196. - PMC - PubMed
    1. Li Y, Chen X, Gong X, He D, Cheng X, Prabahar K, et al. The effect of 17beta-estradiol plus Norethisterone acetate on anthropometric indices: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2023;287:176–85. - PubMed

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