Short-Term Hormonal Replacement Therapy in Postmenopausal Women: Effect on Weight, Caloric Intake, and Metabolic Parameters (original) (raw)
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The Journal of Clinical Endocrinology & Metabolism, 2002
Menopause is associated with decreased lean body mass and increased fat due to aging and declining hormone secretion. Estrogens or estrogen-progestins have been used to alleviate vasomotor symptoms. However, estrogen-androgen (E/A) therapy is also used for vasomotor symptom relief and has been shown to increase lean body mass while decreasing fat mass. The objective of this 16-wk, double-blind, randomized, parallel group clinical trial was to compare esterified estrogen plus methyltestosterone (1.25 mg estrogen ؉ 2.5 mg methyltestosterone/d; E/A group) vs. esterified estrogen alone (1.25 mg/d; E group) on body composition. Forty postmenopausal women (mean age, 57 yr) participated. Compared with estrogen treatment alone, women in the E/A group increased their total lean body mass and reduced their percentage fat for all body parts (P < 0.05). After E/A treatment, there were statistically significant increases in lean body mass by 1.232 kg [0.181 ؎ 0.004, 0.81 ؎ 0.057, and 0.24 ؎ 0.009 kg in the upper body (P ؍ 0.021), trunk (P ؍ 0.001), and lower body (P ؍ 0.047), respectively]. In the E group, the increase was 0.31 ؎ 0.004, 0.021 ؎ 0.03, and 0.056 ؎ 0.05 kg in the upper body, trunk, and lower body, respectively. In the E/A group, body fat was reduced by 0.90 kg (P ؍ 0.18 for the trunk only), and percentage body fat declined by 7.4% (P < 0.05 for all body parts). Lower body strength increased by 23.1 kg (51 lb) in the E/A group vs. only 11 kg (24.25 lb) in the E group (P ؍ 0.002 between groups). A statistically significant increase in weight (2.7 ؎ 5.1 vs. 0.1 ؎ 4.6 lb; P < 0.05) was observed in the E/A group compared with the E group. When subjects were given self-reporting questionnaires, more improvement was noted in sexual functioning and quality of life in the E/A group when compared with patients receiving E alone. There were no noteworthy side effects. In conclusion, E/A replacement therapy can improve body composition, lower-body muscle strength, quality of life, and sexual functioning in postmenopausal women.
American Journal of Clinical Nutrition
It has been suggested that hormone therapy may help counter undesirable changes in body composition in older women. This study was designed to test whether estrogen plus progestin (E+P) therapy favorably affects age-related changes in body composition in postmenopausal women. The substudy was composed of 835 women from the estrogen plus progestin trial of the Women's Health Initiative who were randomly assigned to receive either E+P therapy (n = 437) or placebo (n = 398). The women had a mean age of 63.1 y and, on average, were 13.8 y past menopause. More than 17% of the participants were from an ethnic minority. No significant differences in baseline body composition (measured with dual-energy X-ray absorptiometry) by intervention assignment were observed. After 3 y of intervention, the women who received active E+P therapy lost less lean soft tissue mass (-0.04 kg) than did the women who received placebo (-0.44 kg; P = 0.001). Additionally, the women in the E+P group had less ...
Weight gain and hormone replacement therapy: are women’s fears justified?
Maturitas, 2000
Fear of weight gain is one of the main factors contributing to the poor compliance seen with hormone replacement therapy (HRT). Although an increase in weight can be a result of rehydration, (which in turn may alleviate some of the effects of skin ageing), many women consider weight gain to be cosmetically unacceptable. Moreover, excess body weight or certain patterns of body fat distribution can lead to health problems such as cardiovascular disease and breast cancer. The menopause is associated with a decrease in the resting metabolic rate that reduces the utilisation of calories and hence increases body weight. A number of studies have shown that weight gain is greatest in the peri-menopausal years. There also appears to be a redistribution of fat mass at the time of the menopause, with an increase in the waist-to-hip ratio. Although it is a common belief that HRT inevitably causes weight gain, available evidence suggests that this is not true. Indeed, some HRT regimens, such as continuous 17b-oestradiol 2 mg/day combined with sequential dydrogesterone 10 mg/day for 14 days/cycle (Femoston ®), may actually help to prevent an increase in body fat mass and fat redistribution. Informing women about the effects of the menopause on body weight/fat distribution and the potential beneficial effects of some HRT regimens should help to improve HRT compliance.
Maturitas, 2005
Objective: The objective of this study was to determine the relationships of serum estrogen levels after hormone replacement therapy (HRT) every other day and every day with body mass index (BMI) in postmenopausal and bilaterally ovariectomized women. Methods: Eighty-six postmenopausal and 51 bilaterally ovariectomized women who had been suffering from vasomotor symptoms such as hot flush or atrophy of the vagina were randomly treated with HRT every other day or every day. Seventy-four patients received oral administration of 0.625 mg conjugated equine estrogen (CEE) and 2.5 mg medroxyprogesterone acetate (MPA) every other day, and 63 patients received oral administration of 0.625 mg CEE and 2.5 mg MPA every day as conventional HRT. Results: Eighty-four postmenopausal and 50 bilaterally ovariectomized women completed this study. Serum estradiol levels after HRT every day in postmenopausal and bilaterally ovariectomized women were significantly (P < 0.05 and <0.01, respectively) correlated with BMI, while those after HRT every other day were not correlated with BMI. The differences between estradiol levels after 12 months of treatment and initial estradiol levels were also significantly (P < 0.01) correlated with BMI in both postmenopausal and bilaterally ovariectomized women who received HRT every day but not in women who received HRT every other day. Serum estrone level after HRT every day and the difference between estrone level after 12 months of treatment and initial estrone level were significantly (P < 0.05 and <0.01, respectively) correlated with BMI only in bilaterally ovariectomized women. Conclusion: Serum estradiol levels after HRT every day increase more in overweight women than in non-overweight postmenopausal and bilaterally ovariectomized women. The results of the present study regarding the relationship between serum estradiol levels after HRT and BMI should be useful for selecting dosages of drugs to be used in HRT.
Influence of Menopausal Hormone Therapy on Body Composition and Metabolic Parameters
BioResearch Open Access
The loss of estrogen with menopause is associated with an increase in central fat. The objective of this study was to evaluate the effects of menopause hormone therapy (HT) on body composition and metabolic parameters in postmenopausal women. A prospective study was conducted among postmenopausal women from the Climacteric clinic, Universidade Federal de São Paulo. Thirty-two participants, median age 51 years, were included. Sixteen women were eligible to receive a low-dose continuous combined HT, containing 1 mg of E2 plus 0.125 mg of trimegestone for 6 months. The other 16 women remained in the control group. In the HT group, significant decreases from baseline were evident for the total cholesterol (TC) (p < 0.05) and LDL levels (p < 0.05). The HDL significantly decreased (p < 0.05). However, the TC/HDL ratio also decreased (p = 0.05). The parameters of body composition, after 6 months of HT, were maintained. In the control group, body mass index levels increased from baseline, however, with nonstatistically significant differences (p = 0.06). Analyzing the body composition showed a significant increase in the trunk body fat (p = 0.04), trunk region fat (p = 0.04), and total region fat (p = 0.03) after 6 months. In conclusion, the present study provides evidence that HT can stunt the increase in total body fat and prevent the shift from a more central fat distribution observed in early postmenopausal period.
Journal of Bone and Mineral Research, 2003
The aim of this study was to study the influence of hormone replacement therapy (HRT) on weight changes, body composition, and bone mass in early postmenopausal women in a partly randomized comprehensive cohort study design. A total of 2016 women ages 45-58 years from 3 months to 2 years past last menstrual bleeding were included. One thousand were randomly assigned to HRT or no HRT in an open trial, whereas the others were allocated according to their preferences. All were followed for 5 years for body weight, bone mass, and body composition measurements. Body weight increased less over the 5 years in women randomized to HRT (1.94 ؎ 4.86 kg) than in women randomized to no HRT (2.57 ؎ 4.63, p ؍ 0.046). A similar pattern was seen in the group receiving HRT or not by their own choice. The smaller weight gain in women on HRT was almost entirely caused by a lesser gain in fat. The main determinant of the weight gain was a decline in physical fitness. Women opting for HRT had a significantly lower body weight at inclusion than the other participants, but the results in the self-selected part of the study followed the pattern found in the randomized part. The change in fat mass was the strongest predictor of bone changes in untreated women, whereas the change in lean body mass was the strongest predictor when HRT was given. Body weight increases after the menopause. The gain in weight is related to a decrease in working capacity. HRT is associated with a smaller increase in fat mass after menopause. Fat gain protects against bone loss in untreated women but not in HRT-treated women. The data suggest that women's attitudes to HRT are more positive if they have low body weight, but there is no evidence that the conclusions in this study are skewed by selection bias. (J Bone Miner Res 2003;18:333-342) Key words: weight, body fat mass, lean body mass, estrogen, menopause the first 2 years after menopause. (10) A steep decline in BMD at the time of menopause has been established, and some women experience an increase in body weight during the same period of life. Many women believe that HRT aggravates the increase in body weight and refuse the The authors have no conflict of interest.