As Women Age, So Do Their Bodies
Within 10 years of menopause, women’s physiologies accumulate metabolic disturbances, including: visceral obesity, systemic inflammation, insulin resistance, dyslipidemia, loss of muscle mass, and hypertension. All of these issues increase the risk of blood sugar issues and diseases such as insulin resistance and type-2 diabetes.
Much of these physical abnormalities are partially explained by estrogen deficiency. Not all of aging, but much of it, is caused by waning of sex steroid hormones.
But, there is a nasty synergism between aging and estrogen deficiency. The two together put aging women at higher risk of type-2 Diabetes, bigger bellies and less quality of life.
All this has been known for a while. But estrogen therapies were out of medical vogue, until recently.
Estrogen Therapy’s Protective Roles Against Diabetes
With the recent “vindication of estrogen” on breast health and the incidence of breast cancer, with proof that estrogen therapy protects against breast cancer, estrogen therapy’s protective roles against diabetes are being reassessed, reproved and recommended by docs that know this literature, which many do not.
Nearly 30 years ago, researchers first examined the association between postmenopausal hormone use and the subsequent incidence type-2 Diabetes. In the Nurse’s study a large group of US postmenopausal women—21,028—aged 30-55 years were followed for 12 years.
- Participants on hormone therapy experienced a 20% reduction in the incidence of type-2 diabetes.
In a prospective French cohort of the Etude Epidemiologique de Femmes de la Mutuelle Générale de l’Education Nationale (E3N) 63,624 postmenopausal women were followed for 15 years.
- Participants on hormone therapy experienced a 20% reduction in the incidence of type 2 diabetes.
In the Heart and Estrogen/Progestin Replacement Study, the effect of hormone therapy on fasting glucose level and incident diabetes in 2,763 postmenopausal women with coronary heart disease were followed at 20 US Centers.
Participants received 0.625 mg of conjugated estrogen plus 2.5 mg of medroxyprogesterone, or placebo, and were followed for 4 years.
- Hormone therapy reduced the incidence of diabetes by 35%.
A meta-analysis of 107 trials in 2006, looked at the effects of hormone therapy on components of metabolic syndrome (which increases the risk of type-2 diabetes) in postmenopausal women .
- In women without diabetes, hormone therapy reduced insulin resistance score by 13% and incidence of type 2 diabetes by 30%.
- In women with diabetes, hormone therapy reduced fasting glucose by 11% and insulin resistance score by 36%.
Twelve weeks of estrogen therapy compared to placebo, on 12 postmenopausal women, showed improved fasting beta-cell function and serum glucose in menopausal women with obesity.
Beta cells make insulin. Estrogen therapy improved beta cell functioning. This is critical information. Estrogen is improving insulin where it is made.
In a randomized, double-blind, placebo-controlled, crossover trial on eight postmenopausal women with obesity, oral estrogens increased [triacylglycerol] synthesis from glucose, without accumulating in the liver.
- In other words, estrogens improved processing of blood fats.
More and more reasons are accumulating to use hormones as power anti-aging and disease prevention tools.
- To age without hormones is to age faster and worse than you need to.
- Get tested and treated individually.
- Everyone is different and not every single body needs hormones. But most do.
- Be well.
Dr. B.
Related Links
Estrogen’s Vindication Podcast
References:
Estrogen Vindicated eBook Estrogen Vindication 32 page article with 204 citations.
Annals of Epidemiology Volume 2, Issue 5, September 1992, Pages 665-673 A prospective study of postmenopausal estrogen therapy and subsequent incidence of non-insulin-dependent diabetes mellitus
Diabetologia volume 52, pages2092–2100(2009) Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle Générale de l’Education Nationale (E3N)
Molecular Metabolism Volume 3, Issue 2, April 2014, Pages 177-190 Tissue-selective estrogen complexes with bazedoxifene prevent metabolic dysfunction in female mice.
Journal of the Endocrine Society, Volume 3, Issue 8, August 2019, Pages 1583–1594, https://doi.org/10.1210/js.2019-00074 complexes with bazedoxifene prevent metabolic dysfunction in female mice Conjugated Estrogens and Bazedoxifene Improve β Cell Function in Obese Menopausal Women
N Engl J Med. 2016;374(9):803–806. doi:10.1056/NEJMp1514242. Menopause Management–Getting Clinical Care Back on Track
Ann Intern Med. 2003;138(1):1–9. doi:10.7326/0003-4819-138-1-200301070-00005. Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized, double-blind, placebo-controlled trial.
Diabetes Obes Metab. 2006;8(5):538–554. doi:10.1111/j.1463-1326.2005.00545.x. Meta-analysis: effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women.
Medscape Feb 05 2020 Menopause Hormone Therapy Found to Delay Type 2 Diabetes