Estrogen-based hormone therapy may not be associated with reduced loss of lean body mass compared with no hormone therapy in postmenopausal women, find researchers writing in JAMA Network Open last month.
Women have a longer life expectancy than men, but experience more chronic, non-life-threatening conditions after 45 years, including sarcopenia. Hormone therapy is suggested as a potential intervention for age-related muscle weakness, however, it is associated with health risks.
This study was a systematic review and meta-analysis of 12 randomized clinical trials that included 4,474 postmenopausal women (mean age 59 years) undergoing estrogen-based hormone therapy specifically to protect muscle mass. It included 22 hormone treatment intervention arms of which 15 used an estrogen-progesterone combination and seven used estrogen-only treatment. Controls included no treatment or placebo. After an average of two years, seven treatment arms showed a loss of lean body mass and 14 showed a protective effect. Women who received hormone therapy lost 0.06 kg less lean body mass than those who received no hormone therapy or placebo, but this finding was not statistically significant, wrote researchers who were led by Parminder Raina, Ph.D., of McMaster University in Canada.
Women older than 50 years old lose approximately one percent of muscle mass annually. Based on the results of this study, hormone therapy use could increase the amount of sarcopenia-free time to almost 80 years. “However, most women would not live long enough to experience these additional sarcopenia-free years. The small potential benefit for maintaining muscle mass in the general population of postmenopausal women likely does not outweigh the potential risks of prolonged hormone therapy,” researchers reported.
The findings suggest that other interventions should be considered to protect muscle mass in aging women, the authors wrote.
“This systematic review and meta-analysis did not show a significant beneficial or detrimental association of hormone therapy with muscle mass. Although muscle retention in aging women is of crucial importance, these findings suggest that interventions other than hormone therapy should be explored,” the authors wrote.
Ayesha A. Javed, Alexandra J. Mayhew, Alison K. Shea, et al. “Association Between Hormone Therapy and Muscle Mass in Postmenopausal Women: A Systematic Review and Meta-analysis.” JAMA Netw Open. August 28, 2019. doi:10.1001/jamanetworkopen.2019.10154