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Hormone Therapy may help muscle mass

22 June 2020

It has been known for some time that loss of skeletal muscle mass and strength (sarcopenia), occurs with age and causes adverse health outcomes, such as increased risk of falls, fractures, and disability; muscle mass and strength being important for activities of daily living. It is also believed that menopausal transition contributes to sarcopenia, possibly due to detrimental effects from estrogen deficiency. This led to an interest in the possible role of HRT in preventing or reducing sarcopenia.

Back in 2015, the NICE guideline on diagnosis and management of menopause, included review of the role of HRT in maintaining muscle mass and concluded that there was some weak evidence that HRT improves muscle mass and strength. A recently published study provides more information on this important topic.

4,254 postmenopausal women who took part in the Korea National Health and Nutritional Examination Surveys from 2008 to 2011, were investigated to assess the effect of HRT on sarcopenia in postmenopausal women. The measurements used were Appendicular skeletal muscle mass divided by weight (ASM/Wt) and the prevalence of sarcopenia. ASM was measured using dual-energy x-ray absorptiometry (DEXA).

It was found that use of HRT for 13 months or longer was associated with higher muscle mass and lower prevalence of sarcopenia. This was found to be statistically significant in postmenopausal women under age 65 and those with Body Mass Index less than 25.

Limitations of the study include lack of randomisation, and self-reporting of HRT use, which is not objective. Further, a "healthy user bias" could not be excluded. However, this study does provide useful information which may lead to further research. Meanwhile, postmenopausal women should be aware of the risk of developing sarcopenia and be encouraged to include exercise as part of daily routine. Possible prevention of sarcopenia would not be used as the only reason to take or continue HRT, but if HRT is taken for other reasons such as symptom control or treatment or prevention of osteoporosis, it may provide this additional benefit.

Ref: The Association Between Hormone Therapy and Sarcopenia in Postmenopausal Women. The Korea National Health and Nutrition Examination Survey, 2008-2011. Sung-Woo Kim, MD; Rebecca Kim, MD. Menopause. 2020;27(5):506-511.

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