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Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels--an association with mammographic density.
Gynecol Endocrinol. 2005 Feb; 20(2):110-5.GE

Abstract

OBJECTIVE

To compare the effects of tibolone and continuous combined hormone therapy on circulating sex steroids and their binding proteins and their relationship to mammographic density.

STUDY DESIGN

A prospective, double-blind placebo-controlled study. A total of 166 postmenopausal women were equally randomized to receive tibolone 2.5 mg, estradiol 2 mg/norethisterone acetate 1 mg (E2/NETA) or placebo. Serum analyses of sex steroids, insulin-like growth factor (IGF-I) and binding proteins and assessment of mammographic breast density were performed at baseline and after 6 months of treatment.

RESULTS

Estrogens were markedly increased and androgens decreased by E2/NETA. In contrast, tibolone had only a minor influence on circulating estrogens. Sex hormone binding globulin (SHBG) levels were reduced by 50%, while levels of androgens increased. Baseline values of estrone sulfate (E1S), around 1.0-1.1 nmol/l, were increased to 44.7 nmol/l by E2/NETA and to only 1.7 nmol/l by tibolone (p < 0.001). Mammographic breast density displayed a negative correlation with age and body mass index and a positive association with SHBG. After 6 months there was also a negative correlation with levels of free testosterone. Conclusion We found that tibolone and E2/NETA caused distinct differences in estrogen/androgen status and blood levels of possible breast mitogens. The negative association between free testosterone and mammographic density could be a possible explanation for tibolone having less influence on the breast.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden. marie.hofling@kbh.ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

15823831

Citation

Hofling, Marie, et al. "Different Effects of Tibolone and Continuous Combined Estrogen Plus Progestogen Hormone Therapy On Sex Hormone Binding Globulin and Free Testosterone Levels--an Association With Mammographic Density." Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology, vol. 20, no. 2, 2005, pp. 110-5.
Hofling M, Carlström K, Svane G, et al. Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels--an association with mammographic density. Gynecol Endocrinol. 2005;20(2):110-5.
Hofling, M., Carlström, K., Svane, G., Azavedo, E., Kloosterboer, H., & Von Schoultz, B. (2005). Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels--an association with mammographic density. Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology, 20(2), 110-5.
Hofling M, et al. Different Effects of Tibolone and Continuous Combined Estrogen Plus Progestogen Hormone Therapy On Sex Hormone Binding Globulin and Free Testosterone Levels--an Association With Mammographic Density. Gynecol Endocrinol. 2005;20(2):110-5. PubMed PMID: 15823831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels--an association with mammographic density. AU - Hofling,Marie, AU - Carlström,Kjell, AU - Svane,Gunilla, AU - Azavedo,Edward, AU - Kloosterboer,Helenius, AU - Von Schoultz,Bo, PY - 2005/4/13/pubmed PY - 2005/8/23/medline PY - 2005/4/13/entrez SP - 110 EP - 5 JF - Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology JO - Gynecol Endocrinol VL - 20 IS - 2 N2 - OBJECTIVE: To compare the effects of tibolone and continuous combined hormone therapy on circulating sex steroids and their binding proteins and their relationship to mammographic density. STUDY DESIGN: A prospective, double-blind placebo-controlled study. A total of 166 postmenopausal women were equally randomized to receive tibolone 2.5 mg, estradiol 2 mg/norethisterone acetate 1 mg (E2/NETA) or placebo. Serum analyses of sex steroids, insulin-like growth factor (IGF-I) and binding proteins and assessment of mammographic breast density were performed at baseline and after 6 months of treatment. RESULTS: Estrogens were markedly increased and androgens decreased by E2/NETA. In contrast, tibolone had only a minor influence on circulating estrogens. Sex hormone binding globulin (SHBG) levels were reduced by 50%, while levels of androgens increased. Baseline values of estrone sulfate (E1S), around 1.0-1.1 nmol/l, were increased to 44.7 nmol/l by E2/NETA and to only 1.7 nmol/l by tibolone (p < 0.001). Mammographic breast density displayed a negative correlation with age and body mass index and a positive association with SHBG. After 6 months there was also a negative correlation with levels of free testosterone. Conclusion We found that tibolone and E2/NETA caused distinct differences in estrogen/androgen status and blood levels of possible breast mitogens. The negative association between free testosterone and mammographic density could be a possible explanation for tibolone having less influence on the breast. SN - 0951-3590 UR - https://www.unboundmedicine.com/medline/citation/15823831/Different_effects_of_tibolone_and_continuous_combined_estrogen_plus_progestogen_hormone_therapy_on_sex_hormone_binding_globulin_and_free_testosterone_levels__an_association_with_mammographic_density_ L2 - https://www.tandfonline.com/doi/full/10.1080/09513590400021151 DB - PRIME DP - Unbound Medicine ER -