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Title Estrogen and muscle
Date 19 August 2019
Full Story For many years there has been interest in the relationship between menopausal estrogen lack and muscle mass and strength. Indeed, a section on sarcopenia in the NICE guideline on diagnosis and management of the menopause, concluded that Muscle mass and strength decreases with age, and affects daily living and risk of falls. It was stated that there may be an effect from estrogen and that HRT may improve muscle mass and strength.

A recent publication provides further information in this area. A study of 27 postmenopausal women who were either within 6 years, or more than 10 years post menopause took transdermal estradiol or placebo. Muscle samples were analysed.

Use of estrogen reduced muscle protein breakdown in women who were in the early postmenopause, but not in the women who were in late postmenopause.

"Acute estradiol treatment reduces skeletal muscle protein breakdown markers in early but not late-postmenopausal women. Park YM, Keller AC, Runchey SS et al. Steroids 2019 June."

While this is a small study and further research is needed, this does agree with other studies, such as those showing cardiovascular benefit in women who commenced HRT within 10 years of the menopause, but not the same benefit if stared later - the "Window of opportunity".

With the huge concern about increasing osteoporosis and rate of osteoporotic fractures, bone strength is an important aspect, but muscle strength and function is also influential in risk of falling and risking fracture. While estrogen lack, and hence menopause contribute to both reducing bone density and reducing muscle function, the menopause stage is an ideal time for women to take measures to improve both bone strength and muscle strength and function, whether that be form use of HRT, increasing exercise, or both!

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