Testosterone addition during menopausal hormone therapy: effects on mammographic breast density

Abstract

The addition of testosterone does not appear to influence mammographic breast density in women concurrently treated with a common oral estrogen/progestogen regimen for a period of 6 months.

The impact of testosterone, tibolone and black cohosh on purified mammary and placental 17β-hydroxysteroid dehydrogenase type 1

“…Apart from 17bHSD1, previous studies found an inhibitory effect of testosterone on mammary aromatase 43 , and STS activity 23 , respectively. These in vitro findings support the hypothesis of an anti-estrogenic effect of testosterone on the mammary gland, which has previously been postulated [44][45][46] . However, long-term randomized placebo-controlled trials with testosterone in women are missing.…”

Effect of testosterone on E1S-sulfatase activity in non-malignant and cancerous breast cells in vitro

“…First, our finding of an stimulatory effect of "longterm" treatment with T on local estrogen formation in non-malignant, and malignant breast cells in vitro possibly due to posttranslational modifications of STS activity is somewhat contradictory to previous studies showing no adverse effect of T on proliferation in human breast cancer cell lines in vitro [59,60], normal human breast tissue in vivo [18], and on mammographic breast density [17]. However, most studies were performed in the presence of estrogens by for example adding conventional HT to T treatment in postmenopausal women [6][7][8][9]17,61].…”

“…However, most studies were performed in the presence of estrogens by for example adding conventional HT to T treatment in postmenopausal women [6][7][8][9]17,61]. Therefore our study design is better comparable to the Aphrodite trial in which T alone was offered to postmenopausal women with HSDD for 52 weeks.…”

“…However, if this is a finding by chance or due to T therapy remains unclear. The addition of T during combined HT in postmenopausal women has not been shown to influence mammographic density for a period of 6 months [17]. Furthermore T, has been shown to inhibit estrogen/progestogeninduced breast cell proliferation [18].…”

Neutral effect of ultra-low-dose continuous combined estradiol and norethisterone acetate on mammographic breast density

“…An increase in density during hormonal treatment apparently reflects breast tissue remodelling and is also associated with symptoms of pain and discomfort 26 . There is a positive association between increase in density and epithelial cell proliferation, but its major characteristic seems to be a dramatic increase in stromal proteoglycans 20,24,27,28 .…”