Objective : To investigate the effects of phytoestrogen therapy as a selective estrogen receptor modulator (SERM) on several cardiovascular risk estimators and to compare its cardioprotective effects with that of continuous combined hormone replacement therapy (ccHRT).
Study design : Forty healthy non hysterectomised postmenopausal women were involved in this study. Baseline fasting serum total homocysteine (tHcy), lipoprotein (a) [LP (a)], total cholesterol, triacylglycerol (TAG), low density lipoprotein-cholesterol (LDL-c) and high density lipoprotein cholesterol (HDL-c) concentrations were determined as cardiovascular risk estimators. The women were randomly allocated into two groups: the first group (20 cases) received phytoestrogen therapy for 6 months in the form of klimadynon (extract of cimicifuga) as 20 mg tablets (twice daily). The second group (20 cases) received oral ccHRT containing 2 mg estradiol + 1mg norethisterone acetate in the form of kliogest tablets (once daily). The changes in the previous parameters were determined by the end of the 6 months study period to compare the cardioprotective effects of therapy.
Results : The group who received phytoestrogen therapy showed significant reduction in the mean levels of serum LP (a), total cholesterol and LDL-c and a significant increase in the mean level of HDL-c. The group who received ccHRT showed significant reduction in the mean level of tHcy LP(a), total cholesterol and LDL-c. On comparing the changes that occurred with both therapies, ccHRT showed more significant reduction in the mean levels of tHcy, LP (a) and LDL-c while phytoestrogen therapy showed more significant increase in the mean level of HDL-c.