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  • Title: Effects of estrogens and progestogens on lipid metabolism.
    Author: Oster P, Arab L, Kohlmeier M, Mordasini R, Schellenberg B, Schlierf G.
    Journal: Am J Obstet Gynecol; 1982 Mar 15; 142(6 Pt 2):773-5. PubMed ID: 7065057.
    Abstract:
    Because the incidence of venous thromboembolism, coronary heart disease, and stroke is increased in users of oral contraceptives (OCs), the possible causal metabolic side effects of OCs have been widely investigated. In this article we present epidemiologic data associated with OC use. Total plasma triglycerides and cholesterol levels were elevated in OC users while high-density lipoprotein cholesterol levels were lowered. Another section discusses some hormone-dependent physiologic and pathophysiologic aspects of lipid metabolism. Finally, we report on the isolated influence of estrogens and progestogens and their interrelation, including some recent findings about the effects of different progestogens on lipoproteins. The incidence of venous thromboembolism, coronary heart disease, and stroke is increased in users of oral contraceptives (OCs). This article presents epidemiologic data associated with OC use. In a health and nutrition survey of 800 women (20-40 years of age) from Heidelberg, West Germany, fasting blood values, 24-hour urine values, blood pressure readings, fat biopsies, and data on nutritional and medication intakes were recorded. Comparisons were made between current OC users, former users, and those who had never used the pill. Total plasma triglycerides and cholesterol levels were elevated in OC users while high density lipoprotein cholesterol levels were elevated in OC users while high density lipoprotein cholesterol levels were lowered. The epidemiologic experience with users of OCs showed an association between the estrogen content of the pill and venous thromboembolism; therefore, the estrogen dose was lowered. In the low-estrogen OC, significant positive correlations of arterial disease and hypertension with the progestogens content of the pill were noted. There are differences between effects of exogenous and endogenous gonadal hormones in men and women and between single or combined treatment with estrogens and progestogens. Beneficial effects on some lipoproteins can possibly be elicited with certain progestogens. Postmenopausal women might profit from estrogen therapy.
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