Progestogens and cardiovascular disease. A critical review

J Reprod Med. 1999 Feb;44(2 Suppl):180-4.

Abstract

Although progestational hormones are clearly beneficial in preventing estrogen-induced endometrial hyperplasia and cancer, their effect on other areas is far less clear. Of particular interest is the attenuating effect medroxyprogesterone acetate (MPA) has on the cardiovascular benefits of postmenopausal estrogen treatment. MPA reduces the dilatory effect of estrogens on coronary arteries, increases the progression of coronary artery atherosclerosis, accelerates low-density lipoprotein uptake in plaque, increases the thrombogenic potential of atherosclerotic plaques and promotes insulin resistance and its consequent hyperglycemia. These effects may be largely limited to MPA and not shared with other progestogens.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / physiopathology
  • Coronary Artery Disease / physiopathology
  • Disease Progression
  • Estrogens / pharmacology
  • Female
  • Hormone Replacement Therapy / adverse effects*
  • Humans
  • Hyperglycemia
  • Insulin Resistance
  • Lipoproteins, LDL / blood
  • Lipoproteins, LDL / metabolism
  • Medroxyprogesterone Acetate / adverse effects*
  • Medroxyprogesterone Acetate / pharmacology
  • Progesterone Congeners / adverse effects*
  • Progesterone Congeners / pharmacology
  • Progestins / adverse effects
  • Progestins / pharmacology*

Substances

  • Estrogens
  • Lipoproteins, LDL
  • Progesterone Congeners
  • Progestins
  • Medroxyprogesterone Acetate