Objective: To evaluate the links between hormone replacement therapy and lipid-lipoprotein concentrations (total cholesterol [T.Ch] triglycerids, high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C] and very low density lipoprotein cholesterol [VLDL-C]) in a total of 6416 postmenopausal women. Study design: Open prospective longitudinal study. Of the 2184 surgical postmenopausal women, 1102 received conjugated equine estrogen (CEE), and 1082 transdermal estradiol (TDE2). Of the 4232 natural postmenopausal women: 1073 received CEE+medroxyprogesterone acetate (MPA), 1068 CEE+dydrogesterone (DD), 1044 TDE2+MPA, 1047 TDE2+DD. Lipid-lipoprotein concentrations were evaluated by using a SPSS program at 1,2,3,4,5,6,7 years of therapy and cumulatively. Results: Cumulative evaluation of the data on estrogen only replacement therapy revealed a significant decrease in T.Ch, LDL-C and VLDL-C, and an increase in HDL-C; however, the increase in HDL-C and triglycerids was significantly higher in CEE than TDE2 (P<0.01). Cumulative evaluation of the data on estrogen progestin hormone replacement therapy revealed a significant decrease in T.Ch, LDL-C and an increase in HDL-C for all; however, triglycerides and VLDL levels decreased in TDE2+MPA and TDE2+DD groups (P<0.05). Conclusion: Both the natural and surgical menopause patients were found to have more favorable lipid profiles after treatment with estrogen progesterone combined formulations and estrogen only replacement. (C) 1999 Elsevier Science ireland Ltd. All rights reserved.