ABSTRACT

Objective:

To compare the effects of Norethisterone acetate (NETA) and Drospirenone on thyroid hormones, glisemic control, serum lipid profile and androgen levels.

Material method:

50 postmenopausal women with intact ovaries & uterus who have vasomotor complaints but otherwise healthy were prospectively enrolled into the study and 41 of them completed the study. Patients were randomly divided into two groups and prescribed 1mg E2 / 0.5 mg NETA (n=21) or 1mg 17 β E2 / 2 mg Drospirenon (n=20) for 3 months. After the treatment thyroid hormones, glisemic control, lipid profile and androgen levels were compared both within the groups and between the groups. For the statistical analysis besides descriptive statistical methods paired and unpaired t test, Mann-Whitney U test and chi square test were used. Statistical significance level was accepted as p≤ 0.05.

Results:

There was no difference regarding body mass index (BMI), endometrial thickness and thyroid hormones both within the groups and between the groups after the treatment. Total cholesterol (p=0.03), insulin (p=0.009), Homeostasis model assessment (HOMA) (p= 0.01) and fibrinogen (p=0.01) levels were decreased in NETA group after three months. In Drospirenon group there was decrease in LDL cholesterol level (p= 0.02), increase in trigliseride level (p=0.04). There was decrement in total testosterone level in both NETA (p=0.0001) and Drospirenon (0.001) groups.

Conclusion:

NETA have beneficial effects on both lipid and carbohydrate metabolism in postmenopausal women. Drospirenon decreases LDL cholesterol while increasing trigliseride level and has no effect on carbohydrate metabolism. Under the light of these data it is wise to suggest NETA containing low dose hormone therapy preparations in postmenopausal women with diabetes risk for controlling vasomotor complaints.