Hormone Therapy Reduced Insulin Resistance in Postmenopausal Women, Study Shows

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Hormone therapy reduced insulin resistance in postmenopausal women, according to the results of a meta-analysis of 17 studies that included more than 29,000 postmenopausal women, according to a recently published news release. The full findings of the analysis were presented at the 2024 Annual Meeting of The Menopause Society, which was held last week in Chicago.

A research team led by Xuezhi Jiang, M.D., Ph.D., from Reading Hospital Tower Health and Drexel University College of Medicine in Pennsylvania, analyzed 17 studies about hormone therapy found through PubMed, Embase, Medline, Cochrane Library and Google Scholar. They identified 5,553 women on estrogen therapy, 9,797 on estrogen and progesterone therapy and 13,937 women given placebo. Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR), which estimates insulin resistance by analyzing fasting blood glucose and insulin levels.

When compared with placebo, women treated with estrogen only had a difference in means of -0.24 and women treated with estrogen and progesterone had a difference in means of -0.42 and -0.14 on the HOMA-IR measure.

Treatment duration in the 17 studies ranged from eight weeks to two years and participants were between 47 and 75 years old.

The combinations of hormone therapy analyzed were:

• oral conjugated equine estrogens (0.3 mg/ day, 0.45 mg/day, 0.625 mg/day),
• oral 17β-estradiol (1 mg/day, 2 mg/day)
• transdermal 17β-estradiol (0.05 mg/day)
• cyclic or continuous use of oral medroxyprogesterone acetate (1.5 mg/day, 2.5 mg/day, 10 mg/day)
• micronized progesterone (200 mg/day),
• dydrogesterone (5 mg/day, 10 mg/day)
• norethisterone acetate (0.5 mg/day, 1 mg/day)
• drospirenone (2 mg/day)
• norethisterone acetate (0.125 mg/day, 0.25 mg/day, 0.5 mg/day, 1 mg/day)

Insulin is a hormone produced by the pancreas that controls cells’ absorption of glucose, or blood sugar. When someone becomes insulin resistant, the body’s cells become less responsive to insulin. However, the pancreas keeps producing glucose, which keeps blood sugar levels elevated. This overproduction of glucose can lead to weight gain and can turn into type 2 diabetes or cardiac disease if left unchecked.

The drop in estrogen levels that occur during menopause trigger insulin resistance. This is why weight gain is common during this stage.

“Estrogen in hormone therapy has anti-inflammatory properties that can reduce chronic inflammation, a condition often associated with insulin resistance,” Jiang explained in an email interview with Managed Healthcare Executive. “In addition, estrogen positively affects glucose and lipid metabolism and improves insulin sensitivity in tissues such as muscle and fat.”

“Hormone therapy (HT) is not just about relieving vasomotor symptoms; it also offers a variety of health benefits, including osteoporosis prevention, reduction of insulin resistance, and improvement in immune modulation, with protective effects against certain autoimmune diseases,” Jiang concluded.