Elevated serum homocysteine concentration in women taking oral hormone replacement therapy

Elevated homocysteine blood concentrations have been associated with increased risk of atherosclerotic disease. Serum levels of this aminoacid raise in women after the menopause, but return to normal values after applying of hormone replacement therapy (HRT). In this study serum homocysteine concentrations were measured in 43 women, aged 40–65 years receiving oral sequential HRT composed of 2 mg of estradiol valerate on days 1–9 days and subsequently 2 mg of estradiol valerate with 0.15 mg of levonorgestel on days 10–21. Serum homocysteine concentrations were evaluated at the beginning and after 6 months of the study with Homocysteine ELISA kit. During the study mean homocysteine concentration increased significantly from 10.7±4.3 mmol/l at the beginning up to 13.4±4.9 mmol/l after 6 months of the therapy; p<0.05.

These preliminary results suggest that oral HRT with estradiol valerate and levonorgestel may have adverse effect on the cardiovascular system during the first 6 months as indicated by elevated serum homocysteine concentrations.