Study OKs combination of hormones Progestin doesn't undercut estrogen

April 15, 1993|By Knight-Ridder Newspapers

Women who take two hormones, estrogen and progestin during and after menopause have fewer risks of developing heart disease than women who receive only estrogen, researchers at the University of Minnesota and elsewhere have found.

While the difference is slight, the discovery relieves concerns among some medical experts that prescribing progestin might counteract the well-established coronary benefits of estrogen therapy, said Aaron Folsom, an associate professor of epidemiology at the university and one of the study's co-authors.

For years, physicians have prescribed estrogen to relieve the unpleasant symptoms of menopause, such as hot flashes. But like many medications, estrogen produces side effects, some good, some bad: It cuts in half the risk of coronary disease, but also increases the risk of uterine cancer.

In an effort to reduce the cancer risk in women who have not undergone hysterectomies, physicians began prescribing progestin. But this raised fears that the combination might counteract the coronary benefits of estrogen.

To find out if those fears were sound, Dr. Folsom and his colleagues analyzed the blood chemistry of 4,958 postmenopausal women between 45 and 64.

The women were from the northwest suburbs of Minneapolis; Jackson, Miss.; Washington County, Md.; and Forsyth County, N.C, and are part of a larger, continuing study involving 16,000 men and women that is designed to determine atherosclerosis risks in the various communities.

The study was published in today's edition of the New England Journal of Medicine.

The researchers discovered that, when combined, estrogen and progestin lowered overall cholesterol levels, boosted levels of HDL, the "good cholesterol," reduced levels of LDL, the "bad cholesterol," and reduced blood clotting factors.

Based on their findings, the researchers concluded that women on estrogen therapy had a 42 percent lower chance of developing heart disease than women who were not taking estrogen. The risks were slightly lower for women who were taking both estrogen and progestin.

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