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Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy.
Fertil Steril. 2001 Mar; 75(3):554-9.FS

Abstract

OBJECTIVE

To determine serum parameters reflective of androgen status in postmenopausal women using two types of hormone replacement therapy (HRT).

DESIGN

Randomized, double-blind, prospective 1-year trial of two oral HRT regimens.

SETTING

University hospital, department of obstetrics and gynecology, menopause clinic.

PATIENT(S)

100 postmenopausal women > or = 45 years.

INTERVENTION(S)

Daily use of the progestogen tibolone (2.5 mg; n = 50) or continuous combined 17-beta-estradiol (2 mg) and norethindrone acetate (E+NA, 1 mg; n = 50).

MAIN OUTCOME MEASURE(S)

Measurements of total testosterone (total T), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A), FSH, and sex-hormone-binding globulin (SHBG), and calculations of free testosterone (free T). Assessment of changes from baseline within and between groups after 6 and 12 months.

RESULT(S)

We found significant differences (% changes) in the tibolone group compared to baseline within the groups after both 6 and 12 months, respectively. Levels of free T doubled, total T decreased slightly, and SHBG decreased by half; DHEAS increased by approximately 20%; and FSH decreased. In the E+NA group, levels of free T, total T, androstenedione, and FSH all decreased, and SHBG increased. Pre-trial levels of DHEAS, A, and total T were significantly higher in the E+NA group. Between groups throughout the study, the changes from baseline were significant due to the different extent of FSH reduction, and opposite changes of free T, SHBG, and DHEAS.

CONCLUSION(S)

Both regimens modify plasma androgens, DHEAS, and SHBG differently. Tibolone decreased the levels of SHBG, and substantially increased free T and to a lesser extent increased DHEAS; this may reflect a modification of adrenal androgen production. Continuous combined estradiol and norethindrone acetate HRT suppressed the peripheral plasma androgens mediated by increased levels of SHBG.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Westfällische Wilhelms-Universität, Münster, Germany. doeren@ukbf.fu-berlin.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11239541

Citation

Dören, M, et al. "Differential Effects On the Androgen Status of Postmenopausal Women Treated With Tibolone and Continuous Combined Estradiol and Norethindrone Acetate Replacement Therapy." Fertility and Sterility, vol. 75, no. 3, 2001, pp. 554-9.
Dören M, Rübig A, Coelingh Bennink HJ, et al. Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy. Fertil Steril. 2001;75(3):554-9.
Dören, M., Rübig, A., Coelingh Bennink, H. J., & Holzgreve, W. (2001). Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy. Fertility and Sterility, 75(3), 554-9.
Dören M, et al. Differential Effects On the Androgen Status of Postmenopausal Women Treated With Tibolone and Continuous Combined Estradiol and Norethindrone Acetate Replacement Therapy. Fertil Steril. 2001;75(3):554-9. PubMed PMID: 11239541.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy. AU - Dören,M, AU - Rübig,A, AU - Coelingh Bennink,H J, AU - Holzgreve,W, PY - 2001/3/10/pubmed PY - 2001/4/17/medline PY - 2001/3/10/entrez SP - 554 EP - 9 JF - Fertility and sterility JO - Fertil Steril VL - 75 IS - 3 N2 - OBJECTIVE: To determine serum parameters reflective of androgen status in postmenopausal women using two types of hormone replacement therapy (HRT). DESIGN: Randomized, double-blind, prospective 1-year trial of two oral HRT regimens. SETTING: University hospital, department of obstetrics and gynecology, menopause clinic. PATIENT(S): 100 postmenopausal women > or = 45 years. INTERVENTION(S): Daily use of the progestogen tibolone (2.5 mg; n = 50) or continuous combined 17-beta-estradiol (2 mg) and norethindrone acetate (E+NA, 1 mg; n = 50). MAIN OUTCOME MEASURE(S): Measurements of total testosterone (total T), dehydroepiandrosterone sulfate (DHEAS), androstenedione (A), FSH, and sex-hormone-binding globulin (SHBG), and calculations of free testosterone (free T). Assessment of changes from baseline within and between groups after 6 and 12 months. RESULT(S): We found significant differences (% changes) in the tibolone group compared to baseline within the groups after both 6 and 12 months, respectively. Levels of free T doubled, total T decreased slightly, and SHBG decreased by half; DHEAS increased by approximately 20%; and FSH decreased. In the E+NA group, levels of free T, total T, androstenedione, and FSH all decreased, and SHBG increased. Pre-trial levels of DHEAS, A, and total T were significantly higher in the E+NA group. Between groups throughout the study, the changes from baseline were significant due to the different extent of FSH reduction, and opposite changes of free T, SHBG, and DHEAS. CONCLUSION(S): Both regimens modify plasma androgens, DHEAS, and SHBG differently. Tibolone decreased the levels of SHBG, and substantially increased free T and to a lesser extent increased DHEAS; this may reflect a modification of adrenal androgen production. Continuous combined estradiol and norethindrone acetate HRT suppressed the peripheral plasma androgens mediated by increased levels of SHBG. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/11239541/Differential_effects_on_the_androgen_status_of_postmenopausal_women_treated_with_tibolone_and_continuous_combined_estradiol_and_norethindrone_acetate_replacement_therapy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(00)01768-4 DB - PRIME DP - Unbound Medicine ER -