A randomized controlled study of the effects of 17beta-estradiol-dydrogesterone on plasma homocysteine in postmenopausal women

Objective: To investigate the effects of oral 17 beta-estradiol (E2)-dydrogesterone on fasting plasma homocysteine concentrations in healthy postmenopausal women. Methods: We studied 27 postmenopausal women who were assigned randomly to either a treatment group (n = 14) or a control group (n = 13), during the first 12 months of the study, treatment consisted of oral E2, 1 mg daily, combined sequentially with dydrogesterone 5 or 10 mg (14 days per 28-day treatment cycle). Thereafter, women were treated with oral E2, 2 mg daily, combined sequentially with dydrogesterone, 10 mg daily (14 days per 28-day treatment cycle) for a period of 3 months. The control group received no treatment. Fasting plasma total homocysteine concentrations were determined at baseline and 3, 12 and 15 months after study entry. Results: At baseline, plasma homocysteine levels did not differ between the groups. After 15 months of hormone treatment mean plasma homocysteine concentration was lowered by 12.6% compared with baseline (P <.001; analysis of variance for repeated measures). Plasma homocysteine levels were not altered in the control group. The interaction between treatment and time for homocysteine levels was significantly different between the groups (P <.001; analysis of variance for repeated measures). The decrease in plasma homocysteine levels correlated inversely with the increase in serum E2 levels after 3 and 12 months of hormone treatment (r = -.54, P <.05 and r = -.56, P <.05, respectively). Conclusion: Plasma fasting homocysteine concentrations are lowered by E2-dydrogesterone therapy in postmenopausal women. (C) 1998 by The American College of Obstetricians and Gynecologists.