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  • Title: [Estrogens, progestins and blood lipids].
    Author: Tikkanen MJ.
    Journal: Duodecim; 1984; 100(22):1500-3. PubMed ID: 6518995.
    Abstract:
    Progestins and estrogens can affect blood lipids and, as a result, contribute to cardiovascular disease. Since the very first studies, scientists have treated progestins and estrogens separately instead of studying their combined effect. Studies have shown that oral contraceptives (OCs) increase the risk of heart attack and brain hemorrhage. Heart attacks are 3-4 times more likely to occur in women aged 25-49 who are using OCs than those who are not. The risk diminishes after use is discontinued, but women aged 40-49 with a long history of OC use remain twice as prone to heart attacks even after giving up these contraceptives. OCs can cause problems with clotting, resulting in coronary and other arterial complications, increasing atherogenic risk. The effect of steroids on clotting and blood pressure must be studied before it can be determined how cardiovascular disease can be prevented. The author advocates the use of natural and synthetic estrogens in small quantities. He recommends the following in particular: progestins of the pregnal series, desogestrel, and a combination of 19-nortestosterone and estrogen. Synthetic estrogens (mestronol, ethinylestradio) increase high density lipoprotein (HDL) cholesterol levels, and androgens reduce them. Except for desogestrel, currently available progestins are related to androgens. It was discovered in 1977 that progestins in the pregnal series can cause tumors in the breast glands of beagles. Synthetic estrogens increase triglyceride levels by accelerating very low density lipoprotein (VLDL) synthesis. Currently available OCs which contain fewer estrogens, do not affect triglyceride levels to any significant degree. Conjugated estrogens are widely used in Anglo-Saxon countries and can cause hypertriglyceridemia. All other estrogens used to treat symptoms of menopause increase HDL cholesterol and reduce atherogenic LDL cholesterol.
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