Effects of treatment with testosterone alone or in combination with estrogen on insulin sensitivity in postmenopausal women

Hong, Zhigang; Carlström, Kjell; Arner, Peter; Hirschberg, Angelica Lindén

doi:10.1016/j.fertnstert.2005.12.039

Cited by 65 publications

(54 citation statements)

References 47 publications

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“…In postmenopausal women, testosterone implants that increased serum total testosterone ∼2 fold were associated with attenuation of the beneficial effects of estrogen implants on central fat distribution but not on lipids over 2 years of therapy [44]. Zang et al reported the effect of testosterone administration in postmenopausal women randomized to treatment with oral testosterone undecanoate, estradiol, or both for 3 months, with testosterone-treated women achieving median testosterone levels within the normal postmenopausal range [45]. A small but significant reduction in insulin-mediated glucose disposal measured by clamp (by 15-20%) was observed in the testosteronealone and testosterone-estradiol groups but not in the estradiol-alone group [45], an effect on insulin action that is unlikely to be detected with less-sensitive methods.…”

Section: Low Dose Androgen Administration In Healthy Postmenopausal Wmentioning

confidence: 99%

Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome?

Corbould

2008

Diabetes Metabolism Res

122

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Hyperinsulinemia as a consequence of insulin resistance causes hyperandrogenemia in women. The objective was to review evidence for the converse situation, i.e. whether androgens adversely influence insulin action. Androgen excess could potentially contribute to the pathogenesis of insulin resistance in women with polycystic ovary syndrome (PCOS), metabolic syndrome/type 2 diabetes, and in obese peripubertal girls. An Entrez-PubMed search was conducted to identify studies addressing the relationship of androgens with metabolic syndrome/type 2 diabetes in women. Studies reporting outcomes of androgen administration, interventions to reduce androgen effects in hyperandrogenemic women, and basic studies investigating androgen effects on insulin target tissues were reviewed. Multiple studies showed associations between serum testosterone and insulin resistance or metabolic syndrome/type 2 diabetes risk in women, but their cross-sectional nature did not allow conclusions about causality. Androgen administration to healthy women was associated with development of insulin resistance. Intervention studies in women with hyperandrogenism were limited by small subject numbers and use of indirect methods for assessing insulin sensitivity. However, in three of the seven studies using euglycemic hyperinsulinemic clamps, reduction of androgen levels or blockade of androgen action improved insulin sensitivity. Testosterone administration to female rats caused skeletal muscle insulin resistance. Testosterone induced insulin resistance in adipocytes of women in vitro. In conclusion, the metabolic consequences of androgen excess in women have been under-researched. Studies of long-term interventions that lower androgen levels or block androgen effects in young women with hyperandrogenism are needed to determine whether these might protect against metabolic syndrome/type 2 diabetes in later life.

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Section: Low Dose Androgen Administration In Healthy Postmenopausal Wmentioning

confidence: 99%

Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome?

Corbould

2008

Diabetes Metabolism Res

122

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“…This suggests that underlying sex--specific characteristics (e.g. hormone levels, adiposity, lifestyle habits, and quantity of muscle mass) are influencing this relationship [243,244]. In short, our study has identified numerous ethnic--specific associations between FAs and markers of IR, and the majority of these associations appeared to be more robust in men.…”

Section: Discussionmentioning

confidence: 57%

Serum fatty acid profiling within distinct lipid fractions provides a more robust indicator of insulin resistance in humans than total triglyceride and fatty acid profiles

Zulyniak

2014

Appl. Physiol. Nutr. Metab.

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“…They showed that TG did not suffer any change in any of the groups, TC decreased in 20 mg/dL in the group of E and T and the LDL reduced significantly both groups, whereas HDL suffered reduction in both users of E and T and increase in the users of only E [20].…”

Section: Discussionmentioning

confidence: 97%

“…Studies have already shown that this combination offers endometrial protection, without the use of progestogens needed [19]. The behavior of the lipid profile in women using the combination E and T is not well defined once the results of the studies already made are very controversial [20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

Use of Androgens in Postmenopausal Women

Britto

2011

J Endocrinol Metab

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During menopause, women may experience greater loss of bone mineral density, leading to a high risk of fractures. Estradiol has great importance in the maintenance of bone micro architecture and estradiol and testosterone combination have high effectiveness in preventing osteoporosis and fractures in post menopausal women. There is an actual trend of using testosterone combined with estradiol in order to improve the hypo androgen symptoms with an important improvement in the quality of life of these women. The behavior of the lipid profile in women using this combination is not well defined once the results of the studies already made are very controversial. This review article aims at evaluating the studies made in the last years that evaluated the impact of the use of androgens in post menopause women over a bone mineral density and the lipid profile. Searches of articles were made on Pubmed from 1980 to 2011. The searches were made with the use of the keywords 'testosterone' or 'androgens' and 'postmenopausal women' and 'bone density' and 'hormone replacement therapy'. In its second phase the 'testosterone' or 'androgens' and 'postmenopausal women' and 'lipoprotein' and 'hormone replacement'. A total of 67 articles were found. After reading their whole content, 09 original articles were included in this review, prospective that evaluated bone mineral density or the lipid profile in patients using hormone therapy in post menopause. The benefits of the use of androgens have been demonstrated in publications resulting from studies with a reduced number of patients, in non-probabilistic samples, and most of them observational. On the other hand, the results converge towards an improvement of the lipid profile and increase in the bone mineral density in the patients in post menopause. The greater limitation of these results lies on the difficulty on determining the isolated effects of the androgens once the studies showed results obtained through HT with estradiol and androgens. Clinical rehearsals in comparison between the use of isolated estradiol and estardiol + testosterone shall clarify the impact of this combination under the lipid profile and bone protection in postmenopausal patients.

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Effects of treatment with testosterone alone or in combination with estrogen on insulin sensitivity in postmenopausal women

Cited by 65 publications

References 47 publications

Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome?

Effects of androgens on insulin action in women: is androgen excess a component of female metabolic syndrome?

Serum fatty acid profiling within distinct lipid fractions provides a more robust indicator of insulin resistance in humans than total triglyceride and fatty acid profiles

Use of Androgens in Postmenopausal Women

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