Effect of Prolonged Use of Estrogens on Circulating Lipids in Patients with Idiopathic Hyperlipemia or

The low incidence of atherosclerosis in premnenopausal woomen and the effects of gonadal extracts on serum lipids indicate the desirability of further clinical and biochemical studies. Ethinyl estradiol was administered to 12 persons with idiopathic hyperlipemia or idiopathic hypercholesteremia. Medication was given for an average period of 16 months and was well tolerated, despite moderate gynecomastia, diminished libido, or uterine bleeding. The effects on the levels of circulating lipids and the clinical feasibility of this therapy are discussed. T HE lower incidence of coronary athero-sclerosis in premenopausal women as compared to men is well established.1 Sex and age differences in levels of serum lipids and lipoproteins suggest an important role of the gonads in the regulation of circulating lipids.2-5 Administration of estrogenic hor-mones to men and women is followed by a fall iii serum lipid levels and alteration in serum lipoprotein patterns.1 ' 6-9 A number of studies have been concerned with the administration of estrogens to patients with coronary artery disease.', 10-16 Patients with idiopathic hyperlipemia or idiopathic hypercholesteremia provide a unique material for the study of disturbances in circulating lipids per se and in relation to lipid deposition in the tissues that often ac-companies these disorders.17 Therefore, a study was undertaken of the long-term use of orally administered ethinyl estradiol, at mini-mum effective doses, in men and women with either disorder. A preliminary report ap-peared previously.18 MATERIALS AND METHODS Selection of Patients. The group with idio-pathic hyperlipemia included 4 men, age 39, 47, 49, and 52, and 2 women, age 49 and 56 (both postmenopausal). Four patients, 3 men and