February 13, 2020
2 min read

Long-term HT mitigates muscle loss for postmenopausal women

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Prolonged use of menopausal hormone therapy is associated with high skeletal muscle mass and a low prevalence of sarcopenia among postmenopausal women, according to findings published in Menopause.

“A decline of estrogen during menopause causes various health problems,” Sung-Woo Kim, MD, assistant professor in the division of endocrinology, department of internal medicine, Daegu Catholic University Medical School, South Korea, told Healio. “The benefits of hormone therapy for postmenopausal women have been described in previous studies. However, the effect of HT on sarcopenia was not clearly determined. In our study, participants with a prolonged history of HT use had significantly higher skeletal muscle mass. These results suggest that HT has a protective effect against muscle loss in postmenopausal women. Sarcopenia influences the development of various diseases and is associated with mortality among older adults, and we expect that HT improves these sarcopenia-related concerns for postmenopausal women.”

Kim and Rebecca Kim, MD, of the department of ophthalmology, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, South Korea, analyzed data from 4,254 postmenopausal women with complete information on HT use who participated in the Korea National Health and Nutritional Examination Surveys between 2008 and 2011. Researchers assessed DXA-derived appendicular skeletal muscle mass, defined as the sum of lean soft tissue mass of the arms and legs, divided by body weight, as well as the prevalence of sarcopenia, stratified by HT use.

Within the cohort, 302 women (7.1%) were prescribed HT for 1 to 12 months, 275 (6.5%) were prescribed HT for more than 13 months (mean, 52.8 months) and 3,656 (86.4%) were not prescribed HT.

Doctor with depressed elderly patient 
Prolonged use of menopausal hormone therapy is associated with high skeletal muscle mass and a low prevalence of sarcopenia among postmenopausal women.
Source: Adobe Stock

Researchers found that appendicular skeletal muscle mass rose across the three HT groups, from a mean of 13.9 kg for women not using HT to 14.2 kg and 14.6 kg for women using HT for less than 12 months and at least 13 months, respectively. Similarly, appendicular skeletal mass divided by weight percentage also rose across the three groups, from 24.8% for women not using HT to 24.8% to 25.1% for women in the short-term and long-term HT groups, respectively.

Conversely, sarcopenia prevalence was lower among long-term and short-term users of HT vs. never users, with rates of 56.7%, 64.4% and 66.1%, respectively. In a model adjusted for reproductive factors, medical history, demographics and nutrition, long-term HT users were 40% less likely to develop sarcopenia compared with never users (HR = 0.6; 95% CI, 0.41-0.88).


Researchers noted that a history of hypertension and less physical activity were independently associated with the prevalence of sarcopenia, and that duration of HT use was linearly associated with the prevalence of sarcopenia (OR = 0.994 per 1 month; 95% CI, 0.989-0.999).

“Our study was a large-scaled study and showed definite association between prolonged use of HT and high skeletal muscle mass,” Sung-Woo Kim said. “However, because the present study is cross-sectional, we could not assess the causal relationship of this association. To clarify the protective effects of HT against sarcopenia, a large-scaled prospective study will be needed.” – by Regina Schaffer

For more information:

Sung-Woo Kim, MD, can be reached at the Division of Endocrinology, Department of Internal Medicine, Daegu Catholic University Medical School, School of Medicine, 33, Duryugongwon-ro 17-gil, Nam-gu, Daegu, Republic of Korea, 42472; email: sungwoocap@cu.ac.kr.

Disclosures: The authors report no relevant financial disclosures.