Recent articles and news on HRT

GROWTH HORMONE REPLACEMENT REVERSES SYNDROME X

Syndrome X involves the cardiovascular disease risk factors of abdominal obesity, high blood pressure, elevated cholesterol and triglycerides, and decreased insulin sensitivity (preventing effective control of blood sugar, leading to non-insulin dependent diabetes). A recent placebo controlled study conducted at Sahlgrenska University Hospital in Sweden provided evidence that long term human growth hormone (HGH) therapy can reduce the morbidity and mortality from cardiovascular disease. The study reported on 30 men, ages 48-66, with the symptoms of syndrome X. These men were treated for 9 months with physiologic doses of human growth hormone or placebo in a double-blind trial. The men receiving the HGH had the following improvements: visceral fat decreased by 18%, subcutaneous fat decreased by 6%, insulin sensitivity improved by 21%, diastolic blood pressure declined by 5 mm Hg, total serum cholesterol dropped by 11%, and serum triglycerides dropped 15%. No changes were noted in the men receiving placebos. The head of the study, Dr. Per Marin, said the main side effect of HGH was fluid retention.

Johannsson G, Marin P, Lonn L, Ottosson M, Stenlof K, Bjorntorp P, Sjostrom L,
Bengtsson BA. Growth hormone treatment of abdominally obese men reduces abdominal fat mass,
improves glucose and lipoprotein metabolism, and reduces diastolic blood
pressure. J Clin Endocrinol Metab. 1997 Mar;82(3):727-34.

LOW TESTOSTERONE A CARDIOVASCULAR RISK FACTOR

Findings of recent studies have demonstrated that low testosterone levels are associated with a higher cardiovascular risk. One such study, recently published by the Journal of Clinical Endocrinology & Metabolism, established a link between low testosterone levels and reduced insulin sensitivity. This and other studies have shown that testosterone supplementation in middle-aged obese men with slightly decreased testosterone levels reduces abdominal fat tissue and improves insulin sensitivity (the cells response to insulin) and fat metabolism. Studies have also shown that testosterone supplementation lowers total and LDL (bad) cholesterol.

Simon D, et al. Association between total testosterone and cardiovascular risk factors in healthy adult men: the Telecom study, Journal of Clinical Endocrinology & Metabolism 1997; 82:682-5.

ESTROGEN IS AN OPTION FOR CANCER SURVIVORS

Some physicians at the September meeting of the North American Menopause Society argued that, for many women, the benefits of hormone replacement therapy far outweigh the risks of a cancer recurrence. These potential benefits include prevention of heart disease, osteoporosis, osteoarthritis, and memory loss. Wendy Brewster, MD, a gynecologic oncology fellow at the University of California, Irvine said "...the standard practice has remained to prohibit breast-cancer survivors from receiving estrogen replacement. Reappraisal of this standard is essential and long overdue." Studies have shown that cancer patients exposed to high levels of estrogen live as long as those who were not exposed to the hormone. One study compared 261 women who had used estrogen prior to being diagnosed with cancer to 6,617 breast cancer patients who never took estrogen. After following these women for nine years, the researchers reported that the patients who took hormones were 10% more likely to have survived than those who did not take hormones. Dr. Richard Santen, a professor of medicine at the University of Virginia Health Sciences Center, stated "...it is reasonable to consider estrogen in women whose prognosis of being cured of breast cancer is excellent. This would include women with small tumors that have not spread to the lymph nodes, patients who have been disease-free for a long period of time, and those who have tumors that do not appear to be sensitive to estrogen." Dr. Brewster added "Instead of warning women against HRT, physicians should consider counseling these patients about the theoretical risks and well-substantiated benefits of estrogen replacement therapy to allow them to make a rational decision on an individual basis."

Carroll L. Estrogen therapy becoming an option for cancer survivors. Medical Tribune. October 9, 1997. 21

TESTOSTERONE MAY BE PROTECTIVE AGAINST ALZHEIMER'S DISEASE

Recent reports have identified a protective effect of estrogen in the development of Alzheimer's disease, and new studies show that testosterone may exert an even stronger preventive effect. Dr. Papasozomenos, a researcher at the University of Texas-Houston Medical School, has been studying the effects of estrogen and testosterone on the brain tissue of rats. The results, which he presented in the June 24 issue of the Proceeding of the National Academy of Sciences, show that testosterone may exert a greater neuro-protective effect than estrogen.

Proceedings of the National Academy of Sciences USA 1997;94:6612-6617

ESTROGEN REPLACEMENT AFTER MENOPAUSE PREVENTS SKIN AGING

An analysis of 3875 women who took estrogen replacement after menopause were evaluated before and after 10 years of estrogen therapy. Careful skin examination showed a decrease in skin wrinkling and dryness in women who took estrogen.

Dunn LB, Damesyn M, et al. Does Estrogen Prevent Skin Aging? Arch Derm 1997;133 (March); 339-342.