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Progestins can reduce the risk for estrogen-induced endometrial cancer in women receiving postmenopausal hormone therapy, but do they compromise the efficacy of treatment in reducing coronary risk factors?
The Postmenopausal Estrogen/Progestin Interventions (PEPI) trial randomized 875 healthy postmenopausal women, aged 45 to 64, to one of five regimens in double-blind fashion: estrogen alone, estrogen plus cyclic medroxyprogesterone acetate (12 days/month), estrogen plus daily low-dose progestin, estrogen plus cyclic micronized progesterone, or placebo. At the end of three years, unopposed estrogen had the greatest beneficial impact on high-density lipoprotein cholesterol levels, raising them by 5.6 mg/dl. The increase in HDL averaged 4.1 mg…