The effect of hormone replacement therapy and/or exercise on skeletal muscle attenuation in postmenopausal women: a yearlong intervention

Abstract

Hormone replacement therapy (HRT) has been reported to exert a positive effect on preserving muscle strength following the menopause, however, the mechanism of action remains unclear. We examined whether the mechanism involved preservation of muscle composition as determined by skeletal muscle attenuation. Eighty women aged 50-57 years were randomly assigned to either: HRT, exercise (Ex), HRT+exercise (ExHRT), and control (Co) for 1 year. The study was double-blinded with subjects receiving oestradiol and norethisterone acetate (Kliogest) or placebo. Exercise included progressive high-impact training for the lower limbs. Skeletal muscle attenuation in Hounsfield units (HU) was determined by computed tomography of the mid-thigh. Areas examined were the quadriceps compartment (includes intermuscular adipose tissue), quadriceps muscles, the posterior compartment and posterior muscles. Muscle performance was determined by knee extensor strength, vertical jump height, and running speed over 20 m. Fifty-one women completed the intervention. Vertical jump height and running speed improved in the HRT and ExHRT groups compared with Co (interaction, P<0.01). For both the quadriceps compartment and quadriceps muscles, HU significantly increased (interaction, P<or=0.005) for HRT, Ex, and ExHRT compared with Co. For the posterior compartment, HU for the HRT and ExHRT were significantly increased compared with Co, while for posterior muscles, ExHRT was significantly greater than Co. Although the effects were modest, the results indicate that HRT, either alone or combined with exercise, may play a role in preserving/improving skeletal muscle attenuation in early postmenopausal women and thereby exert a positive effect on muscle performance.

Muscle function in monozygotic female twin pairs discordant for hormone replacement therapy

“…Previous research has either found 10,11,32 or not found effects of HRT on muscle voluntary force 12,33,34 (see also 14 ). The reasons for the contradictions may come from several factors.…”

Does hormone replacement therapy prevent lateral rotatory spondylolisthesis in postmenopausal women?

“…HRT maintains the power output to a greater extent than isometric strength in postmenopausal women [31]. Using axial CT scans of the mid-thigh, Taaffe [32] showed that HRT preserves or improves skeletal muscle attenuation in early postmenopausal women, and has a positive effect on muscle performance. In our study, we did not observe any difference in muscle strength related to HRT, but our measurements were done at the biceps, which might not reflect muscle strength in the trunk.…”

Raloxifene and body composition and muscle strength in postmenopausal women: a randomized, double-blind, placebo-controlled trial

“…Studies have shown that hormone replacement therapy (HRT) prevents the shift in body fat distribution to a more central location (5)(6)(7) and diminishes the loss of muscle strength (8)(9)(10)(11)(12)(13)(14)(15). Unfortunately, HRT use is accompanied by adverse side effects, such as an increased risk of breast cancer and cardiovascular disease (16), and for this reason its long-term use is not advocated.…”