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CARDIOVASCULAR EFFECTS A. Effects on Lipids One reason physicians choose not to prescribe estrogen–androgen hormonal replacement therapy stems partly from concern that its use may reverse the increased serum concentration of high-density lipoprotein (HDL) cholesterol that is achieved by estrogen replacement therapy alone. This argument fails to take into consideration that estrogen– androgen HRT significantly lowers serum triglycerides levels, in contrast to ERT alone, which elevates them (22). 5 mg/day methyltestosterone in a doubleblind, randomized, 2-year, parallel-group study of 60 surgically menopausal women.

Patients were randomized to one of the two treatments for one year. 2%) bone mineral densities. Patients who continued taking oral estrogen therapy had no change in bone mineral density. Hormone Replacement Therapy and Androgens 47 Davis and McCloud (10) investigated the effects of estrogen– androgen therapy on bone density in a prospective, 2-year, single-blind trial in 34 menopausal women. Patients were assigned to either estradiol implants (50 mg) or to estradiol (50 mg) plus testosterone (50 mg) implants every 3 months.

POSTPARTUM AND LACTATING WOMEN Combined oral contraceptives are not the contraceptive of choice for breastfeeding mothers. There is well-proven evidence of a decrease in milk supply, even for those taking low-dose preparations [39]. There is controversy about when to start the oral contraceptive in nonbreastfeeding mothers as to whether there is an increased risk of thromboembolic events immediately in the postpartum period [39]. No specific information is currently available about preparations containing 15, 20, and 25 µg of synthetic estrogen with respect to initiation in the postpartum period or during lactation.

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