Mia Evans

University of Nottingham
United Kingdom

Abstract Title: Effect of Different Types of Menopausal Hormone Therapy (MHT) on the Lipid Profile of Women During the Menopausal Period: A Scoping Review

Biography: Mia Evans is a third-year undergraduate student at the University of Nottingham, currently working towards a Biomedical Science degree followed by an integrated Medicine degree. They have a clinical and academic interest in women’s health. Their current research focuses on the effects of different types of menopausal hormone therapy on lipid profiles of individuals in the menopausal transition, with consideration of how this has implications on cardiovascular disease risk.

Research Interest: Background - The menopause occurs due to cessation of ovarian function, resulting in reduced 17b-oestradiol (E2) levels. Menopausal hormone therapy (MHT) is offered to women, commonly including oestrogen, which is recognised to alleviate menopausal symptoms, and progesterone, if women require endometrial protection. Current research provides limited evidence comparing how different types of MHT influences lipid profiles, despite derangement of lipids being associated with cardiovascular disease. Objectives - To characterise evidence regarding how different types of MHT influences individual lipid markers in women during the menopausal period, including comparing oestrogen monotherapy to combined MHT. Methods - This scoping review followed PRISMA-ScR guidelines. MEDLINE, Embase and PyscINFO databases were searched for studies published in the last 10 years, generating 1966 papers for screening. 10 primary studies were included and data such as population criteria, MHT regimens and lipid profiles was extracted by two reviewers, independently. Results - In comparison to E2 and oestradiol valerate, conjugated equine oestrogen monotherapy most consistently improved total cholesterol, high-density lipoprotein cholesterol and lipoprotein(a) levels, with triglyceride outcomes inconsistent. The addition of micronised progesterone or dydrogesterone resulted in the smallest attenuation of beneficial oestrogenic effects, whilst medroxyprogesterone acetate produced the greatest attenuation. Conclusion - Findings suggest that the type of MHT selected has an impact on lipid profiles. Oestrogen-only therapy, particularly conjugated equine oestrogen, most consistently improved lipid profiles, with the addition of progestogens often reducing this effect. Associations between MHT and lipid profiles should therefore potentially be discussed during consultations aiding informed decision-making for menopausal women. The small number of studies, lack of generalisability and heterogenous regimens in this study means cautious interpretation of results is required, alongside further high-quality research.