Effects of hormone replacement therapy on glucose and lipid metabolism in peri- and postmenopausal women with a history of menstrual disorders

Abstract

Background Previous studies have indicated that women with a history of menstrual disorders have an increased risk of metabolic and cardiovascular diseases. This has been attributed to the high proportion of polycystic ovary syndrome (PCOS) among this group. The favorable effects of hormone replacement therapy (HRT) on serum lipid profiles and glucose homeostasis in postmenopausal women is widely accepted. Whether HRT can also show positive effects on metabolic homeostasis in menopausal women with prior menstrual disorders (a putative PCOS phenotype) has not been reported yet. The aim of the study was to compare the effects of HRT on glucose and lipid metabolism in peri- and postmenopausal women with prior menstrual disorders and controls who did not have prior menstrual disorders. Methods A retrospective multicenter study was conducted including 595 peri- and postmenopausal women who received HRT at four hospitals in the Zhejiang Province from May 31, 2010 to March 8, 2021. Participants were divided into the Normal menstruation group and the Menstrual disorders group according to their prior usual menstrual cycle pattern. Glucose and lipid metabolism indicators were assessed at baseline and after HRT. The results were compared between and within the groups, and data from peri- and postmenopausal women were analyzed separately. Results HRT significantly decreased fasting insulin and homeostasis model assessment of insulin resistance in perimenopausal users, and fasting plasma glucose levels in postmenopausal users with prior menstrual disorders, compared with baseline. Furthermore, HRT decreased low-density lipoprotein cholesterol, total cholesterol, fasting insulin, fasting plasma glucose and homeostasis model assessment of insulin resistance in both peri- and postmenopausal controls, compared with baseline. Nevertheless, no significant differences were observed in any of the glucose or lipid metabolism indicators at baseline and follow-up, as well as changes from baseline levels between menopausal women with and without prior menstrual disorders. Conclusions HRT shows more obvious within-group improvements in glucose and lipid metabolism in controls, but there is no significant between-group difference. Further prospective studies are required for confirmation.

Association between MetS-IR and prediabetes risk and sex differences: a cohort study based on the Chinese population

“…First, the main reason may be related to the fact that the majority of women diagnosed with prediabetes in this study were postmenopausal women (about 70% of women were over 50 years old). It is well known that estrogen is an important regulator of IR, and postmenopausal women are more prone to lipid disorders due to the lack of estrogen (41,42), which in turn causes central fat deposition and abdominal obesity in postmenopausal women (43)(44)(45), and harmful lipid deposition promotes the development of prediabetes. Additionally, the literature reported that women are inherently more prone to IR, but sex hormones, environment, and good lifestyle factors can improve the "genetic disadvantage" of women (46).…”

Status of female sexual dysfunction among postmenopausal women in Bangladesh

“…Reduced estrogen production affects sexual function directly, and regular intake of HRT can improve that. Different studies have focused on its role, which showed its effect on fasting plasma glucose levels, low-density lipoprotein, and total cholesterol in peri- and postmenopausal women [ 50 ]. HRT enhances sexual function in a statistically significant way; hence the level of sexual satisfaction is better in postmenopausal women with HRT than those without HRT [ 51 ].…”

Association of follicle stimulating hormone and serum lipid profiles in postmenopausal women

“…Some studies found that HRT had no significant impact on the lipid profile, and some women still developed dyslipidemia despite HRT. [4] Other findings from large randomized trials also do not confirm the benefit of estrogen therapy for the prevention of cardiovascular disease, and HRT is not recommended for this purpose in clinical practice. [7] Clinically, we also found that by using HRT, although FSH decreased, no effect on the lipid profile was found.…”

“…Some studies found that hormone replace therapy (HRT) had no significant impact on lipid profiles. [ 4 ] Recent studies focus on the association between FSH and cardiometabolic factors including serum lipids, but the results are controversial whether FSH is negatively or positively associated with dyslipidemia in postmenopausal women.…”