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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

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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