"I’m going to stay young":  Belief in anti-aging efficacy of menopausal hormone therapy drives prolonged use despite medical risks

Hunter, Mary M.; Huang, Alison J.; Wallhagen, Margaret

doi:10.1371/journal.pone.0233703

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…The data is in this study indicate that the benefits of hormone replacement therapy for muscle function are long lasting even after cessation of said therapy. This may have significant implications as a limited duration of hormone replacement therapy will diminish the often reported risks of developing cancer and cardiovascular diseases [ 86 ] and hence may increase the number of women that can safely be prescribed short duration hormone replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

A prolonged hiatus in postmenopausal HRT, does not nullify the therapy’s positive impact on ageing related sarcopenia

et al. 2021

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Background Previous work suggest a positive skeletal muscle effect of hormone replacement therapy (HRT) on skeletal muscle characteristics This study aimed to quantify any continued positive effect of HRT even after a sustained hiatus in treatment, controlling for two key muscle modulation hormones: Estradiol (E2) and Tri-iodo-thyronine (T3). Method and findings In 61 untrained women (18-78yrs) stratified as pre-menopausal, post-menopausal without (No_HRT) and post-menopausal with (Used_HRT) HRT history, body composition, physical activity, serum E2 and T3 were assessed by dual energy x-ray absorptiometry, Baecke questionnaire and ELISA. Gastrocnemius medialis (GM) and tibialis anterior (TA) electromyographic profiles (mean power frequency (mPowerF)), isometric plantar-flexion (PF) and dorsi-flexion (DF) maximum voluntary contraction (MVC), rate of torque development (RTD), isokinetic MVC and muscle volume, were assessed using surface electromyography, dynamometry and ultrasonography. Muscle quality was quantified as MVC per unit muscle size. E2 and E2:T3 ratio were significantly lower in postmenopausal participants, and were positively correlated with RTD even after controlling for adiposity and/or age. Pre-menopausal females had greater MVC in 8/8 PF and 2/5 DF (23.7–98.1%; P<0.001–0.049) strength measures compared to No_HRT, but only 6/8 PF (17.4–42.3%; P<0.001–0.046) strength measures compared to Used_HRT. Notably, Used_HRT had significant higher MVC in 7 PF MVC (30.0%-37.7%; P = 0.006–0.031) measures than No_HRT, while premenopausal and Used_HRT had similar uncorrected muscle size or quality. In addition, this cross-sectional data suggest an annual reduction in GM muscle volume corrected for intra-muscular fat by 1.3% in No_HRT and only 0.5% in Used_HRT. Conclusion Even years after cessation of the therapy, a history of HRT is positively associated with negating the expected post-menopausal drop in muscle quantity and quality. Whilst mPowerF did not differ between groups, our work highlights positive associations between RTD against E2 and E2:T3. Notwithstanding our study limitation of single time point for blood sampling, our work is the first to illustrate an HRT attenuation of ageing-related decline in RTD. We infer from these data that high E2, even in the absence of high T3, may help maintain muscle contractile speed and quality. Thus our work is the first to points to markedly larger physiological reserves in women with a past history of HRT.

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Section: Discussionmentioning

confidence: 99%

A prolonged hiatus in postmenopausal HRT, does not nullify the therapy’s positive impact on ageing related sarcopenia

et al. 2021

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“…The WHI found synthetic HRT had many more negative effects than expected; HRT use dropped alarmingly after subsequent publicity altered prescribing patterns [14]. Yet HRT still dominates the pharmaceutical market with annual valuations consistently reaching billion-dollar levels [15][16][17][18].…”

Section: Cultural Contextsmentioning

confidence: 99%

The Scientific and Cultural Journey to Ovarian Rejuvenation: Background, Barriers, and Beyond the Biological Clock

Sills

2021

Medicines

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Female age has been known to define reproductive outcome since antiquity; attempts to improve ovarian function may be considered against a sociocultural landscape that foreshadows current practice. Ancient writs heralded the unlikely event of an older woman conceiving as nothing less than miraculous. Always deeply personal and sometimes dynastically pivotal, the goal of achieving pregnancy often engaged elite healers or revered clerics for help. The sorrow of defeat became a potent motif of barrenness or miscarriage lamented in art, music, and literature. Less well known is that rejuvenation practices from the 1900s were not confined to gynecology, as older men also eagerly pursued methods to turn back their biological clock. This interest coalesced within the nascent field of endocrinology, then an emerging specialty. The modern era of molecular science is now offering proof-of-concept evidence to address the once intractable problem of low or absent ovarian reserve. Yet, ovarian rejuvenation by platelet-rich plasma (PRP) originates from a heritage shared with both hormone replacement therapy (HRT) and sex reassignment surgery. These therapeutic ancestors later developed into allied, but now distinct, clinical fields. Here, current iterations of intraovarian PRP are discussed with historical and cultural precursors centering on cell and tissue regenerative effects. Intraovarian PRP thus shows promise for women in menopause as an alternative to conventional HRT, and to those seeking pregnancy—either with advanced reproductive technologies or as unassisted conceptions.

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“…Of particular note, MHT use has been associated with an increased risk for stroke, 23 and cerebral thrombi and microthrombi may lead to cognitive decline. Maintaining cognitive ability and preventing Alzheimer’s disease (AD) are important self-reported motivators for patients’ use of MHT, though qualitative research has indicated that patients continue to express particular confusion about the potential impact of MHT on cognition, driven by their perception of conflicting reports and inconsistent information over time 24 . In this context, we conducted a broad search of published literature addressing MHT, focused primarily on studies performed in human populations, and we synthesized the collective findings of several decades into a narrative review summarizing both the neurobiological background for the hypothesis that MHT could alter cognitive outcomes and the current understanding of MHT’s role in preventing cognitive decline and dementia and in treating AD and depression-related cognitive dysfunction.…”

mentioning

confidence: 99%

Menopausal Hormone Therapy and the Mind: The Role of Hormone Replacement in the Prevention and Treatment of Cognitive Decline, Dementia, and Cognitive Dysfunction of Depression

Koire

Joffe

Buckley

2022

Harv Rev Psychiatry

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Learning objectivesAfter participating in this activity, learners should be better able to:• Outline the clinical recommendations for menopausal hormone treatment related to cognitive concerns• Debate and discuss the various research pieces on the use of menopausal hormone therapy cognitive decline, dysfunction, and dementiaAbstractMenopause has been associated with subjective cognitive dysfunction and elevated rates of depression. While menopausal hormone therapy (MHT) is Food and Drug Administration–approved for the treatment of vasomotor symptoms related to menopause, a potential role for MHT in treating and preventing cognitive decline, dysfunction, and dementia has remained unclear and a topic of continued interest and debate across decades of research. Increasing numbers of patients are seeking help for subjective cognitive decline, and those with poorer mental health are substantially more likely to perceive themselves to be at high risk of developing dementia; thus, mental health professionals are likely to encounter such patients and may be asked to provide advice concerning MHT, cognition, and indications for MHT use. Here, we synthesize the neurobiological effects of MHT, make recommendations for its use in current clinical practice in the contexts of cognitive dysfunction associated with major depressive disorder, cognitive decline, and Alzheimer’s disease, and discuss the frontiers being explored by ongoing research on this topic. We conclude that MHT to improve cognitive functioning has only a few scenarios where it would be recommended and that particular caution may be warranted for carriers of the APOE ε4 allele.

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"I’m going to stay young": Belief in anti-aging efficacy of menopausal hormone therapy drives prolonged use despite medical risks

Cited by 7 publications

References 17 publications

A prolonged hiatus in postmenopausal HRT, does not nullify the therapy’s positive impact on ageing related sarcopenia

A prolonged hiatus in postmenopausal HRT, does not nullify the therapy’s positive impact on ageing related sarcopenia

The Scientific and Cultural Journey to Ovarian Rejuvenation: Background, Barriers, and Beyond the Biological Clock

Menopausal Hormone Therapy and the Mind: The Role of Hormone Replacement in the Prevention and Treatment of Cognitive Decline, Dementia, and Cognitive Dysfunction of Depression

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