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Climacteric. 2010 Feb;13(1):55-62. doi: 10.3109/13697130902914650.

Effect of non-oral estrogen on risk markers for metabolic syndrome in early surgically menopausal women.

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Zekai Tahir Burak Women's Health Research Hospital, Department of Reproductive Endocrinology, Ankara, Turkey.



Postmenopausal women are at an increased risk of cardiovascular disease and metabolic syndrome as many risk factors are aggravated by menopause. Elevated levels of homocysteine, triglyceride and asymmetric dimethylarginine (ADMA) have been recognized as risk factors for metabolic syndrome. The present study aimed to investigate the effect of transdermal estrogen treatment on serum levels of atherogenic amino acids, homocysteine, triglyceride, high density lipoprotein (HDL) cholesterol and ADMA in women with surgical menopause.


A prospective study was conducted in 85 surgically menopausal Turkish women at the Department of Menopause of Dr Zekai Tahir Burak Women's Health Research and Education Hospital between March 2007 and March 2008. Subjects were divided into two groups: a treatment group (Group 1) and control (Group 2). Group 1 (n = 46) received transdermal estrogen while Group 2 (n = 39) received no treatment. Body mass index (BMI) and levels of serum homocysteine, ADMA, triglyceride and HDL cholesterol were analyzed postoperatively at the first visit (baseline) and 6th months.


The two groups did not differ in age, baseline BMI and levels of ADMA, homocysteine and triglyceride. In Group 1, values of serum ADMA, homocysteine, triglyceride and HDL cholesterol levels were not different at baseline and at the 6-month visit (p = 0.996, p = 0.564, p = 0.113 and p = 0.173, respectively). On the other hand, the baseline and the 6th month measurements of serum ADMA, homocysteine and HDL cholesterol levels were significantly different in Group 2 (p = 0.001, p = 0.001, and p = 0.023, respectively).


Transdermal estrogen treatment has a protective effect against the risk factors of metabolic syndrome (homocysteine, ADMA, HDL cholesterol) in surgically menopausal patients who have undergone surgery in the early premenopausal period.

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