Estrogen therapy can help keep joint pain at bay after menopause for women who have had a hysterectomy. Joint pain was modestly, but significantly, lower in women who took estrogen alone than in women who took placebo in the Women's Health Initiative (WHI) trial. The findings were published online in Menopause, the journal of The North American Menopause Society.
Studies looking at how estrogen affects joint pain in women after menopause have had mixed results. But this analysis of data on some 1,000 women who had hysterectomies - representative of the more than 10,000 women in this randomized trial - makes it clear that estrogen alone is indeed helpful for joint pain. At the beginning of the study, 77% of these women had joint pain. But after three years, 80% of the women who took a placebo had joint pain, but only 74% of the women in the estrogen group did. The difference was seen only in the estrogen-alone portion of the WHI trial and not in the part of the trial that compared results in women who took an estrogen-progestogen combination with those who took a placebo. (Women with an intact uterus need to use both hormones if they take hormone therapy.)
Women and their healthcare providers who are thinking about estrogen to help prevent joint pain need to take all the risks and benefits of menopausal hormone therapy into consideration and should still follow the recommendation to use the lowest dose for the shortest amount of time needed to achieve the therapeutic goal, the authors emphasized. www.vivenaturalhormones.com
In men with testosterone deficiency, hormone replacement therapy improves symptoms of metabolic syndrome, say researchers. Metabolic syndrome comprises a cluster of complications that can increase the risk of heart and blood-vessel disease as well as type 2 diabetes. These complications include excess body weight, especially around the waist and torso, and abnormal concentrations of fat in the blood, known as lipids. In particular, patients with metabolic syndrome have high blood levels of the so-called bad fats, or triglycerides and low-density lipoproteins, and insufficient amounts of the healthy fats known as high-density lipoproteins. In addition, they often have high blood pressure and sugar, or glucose, levels. Previous research has linked metabolic syndrome to testosterone deficiency, which can cause decreased muscle and bone mass, depression, low energy, and decreased sex drive and ability. In addition, testosterone deficiency is also associated with the individual symptoms of metabolic syndrome, even when they are present without the other complications.
"When indicated, testosterone treatment is both essential and safe in elderly patients with symptomatic late onset hypogonadism, or testosterone deficiency," said study lead author Aksam A. Yassin, M.D., Ph.D., Ed.D., chairman of the Institute of Urology & Andrology in Norderstedt-Hamburg, Germany. "Further analysis is needed to confirm if our findings are due to a direct effect of restoring physiologic testosterone levels."
Specifically, investigators found that the prevalence of metabolic syndrome dropped from 56 to 30 percent after 57 months of treatment with testosterone-replacement medication to regulate hormone levels. In addition, triglycerides, and levels of blood sugar and pressure significantly decreased, while the average waist circumference shrank by 11 centimeters.
Beginning in 2004, investigators collected data from 261 patients with late-onset hypogonadism, characterized by both low testosterone levels and sexual dysfunction, at three centers in Germany. Patients received 1,000 milligrams of a long-acting testosterone drug, called undecanoate, on the first day of the study, at week six, and then every three months. At each visit, patients underwent testing of hormone levels, blood-sugar and lipid concentrations, and blood pressure. Average follow-up was four and a quarter years.
"We hypothesized that long-term testosterone improves metabolic syndrome, and found that this intervention improved all three components of obesity, including waist circumference, weight, and body-mass index; diabetes control; poor lipids profile; and blood pressure," Yassin said. To determine the presence of metabolic syndrome among study participants, investigators used the definition from the International Diabetes Federation. Participants were diagnosed with the syndrome if they displayed central-body obesity combined with two other risk factors. These included elevated triglycerides levels, decreased high-density lipoproteins, high blood pressure, and excessive blood-sugar concentrations. www.vivenaturalhormones.com
