Objective: To determine the effects of different preparations of hormone therapy (HT) on lipid and glucose metabolism, coagulation factors, and bone mineral density (BMD) in overweight and obese postmenopausal women. 

Design: A randomized, nonblinded, controlled study. 

Setting: Karadeniz Technical University, Department of Obstetrics and Gynecology. 

Patient(s): A total of 352 overweight and obese (body mass index > 25 kg/m(2)) postmenopausal women. 

Intervention(s): Ninety women received 2.5 mg of tibolone; 84 received 2 mg of E-2 plus 1 mg of norethisterone acetate (E-2/NETA); 90 received 0.625 mg of conjugated equine estrogen plus 2.5 mg of medroxyprogesterone acetate (CEE/MPA); and 88 did not receive any menopausal therapy (control). 

Main Outcome Measure(s): At baseline and after 6 months of treatment, we measured total cholesterol, triglyceride, high-density lipoprotein cholesterol (LDL), insulin, glucose, factor VII, factor VIII, von Willebrand factor, antithrombin III, protein S, protein C, fibrinogen, and BMD at the lumbar spine L-1-L-4. 

Result(s): There were no statistically significant differences among the groups for any variables at baseline. After 6 months of treatment, the three regimens decreased total cholesterol, triglyceride, LDL, and fibrinogen; E-2/NETA and CEE/MPA increased HDL, and tibolone increased HDL, higher insulin concentrations were found in the control and tibolone groups. Body mass index, HDL, fibrinogen levels, and L-1-L-4 BMD were independent factors in the prediction of HT use. 

Conclusion(s): Body mass index, HDL, fibrinogen levels and L-1-L-4 BMD were independent factors in the prediction of HT use. Treatment with tibolone, E-2/NETA, and CEE/MPA resulted in minimal improvement in lumbar spine BMD but had a beneficial effect on the procoagulation system, with minimal changes in glucose metabolism after 6 months of therapy.