Effect of Estrogen/Progestin Potency on Lipid/Lipoprotein Cholesterol

Authors:
  • PWPatricia Wahl
    Patricia Wahl
  • CWCarolyn Walden
    Carolyn Walden
  • RKRobert Knopp
    Robert Knopp
  • JHJoanne Hoover
    Joanne Hoover
  • RWRobert Wallace
    Robert Wallace
  • GHGerardo Heiss
    Gerardo Heiss
  • BRBasil Rifkind
    Basil Rifkind
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Abstract
We studied 374 women taking oral contraceptives, 284 women taking estrogen preparations after menopause, and 1086 women taking no hormones, to determine the relation of plasma lipids and lipoprotein cholesterol concentrations to various types of estrogen/progestin formulations. Premenopausal women, using oral contraceptives containing a relatively low dose of estrogen combined with a medium or high dose of progestin (Norlestrin, Ovral, or Demulen) had a 24 per cent higher median concentration of low-density-lipoprotein cholesterol than did those not using hormones (P<0.05). Women using oral contraceptives that are high in estrogen and low in progestin (Enovid or Oracon) had significantly higher concentrations of high-density-lipoprotein cholesterol than did nonusers; those using Ovral, a low-estrogen and high-progestin formulation, had significantly lower levels of high-density-lipoprotein cholesterol. In postmenopausal women the use of estrogen was associated with concentrations of low-density-lipoprotein cholesterol that were 11 to 19 per cent below the levels in postmenopausal women who did not use hormones. The effects of estrogen-progestin balance on low-density and high-density lipoproteins may underlie the increased incidence of stroke and myocardial infarction in women of childbearing age who take oral contraceptives. (N Engl J Med. 1983; 308: 862–7.)

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