Eur J Endocrinol
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DOI: 10.1530/eje.1.02065
European Journal of Endocrinology, Vol 154, Issue 1, 131-139
Copyright © 2006 by Society of the European Journal of Endocrinology
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CLINICAL STUDY

Influence of methyltestosterone postmenopausal therapy on plasma lipids, inflammatory factors, glucose metabolism and visceral fat: a randomized study

Lenora M Camarate S M Leão1,3, Mônica Peres C Duarte1, Dalva Margareth B Silva1, Paulo Roberto V Bahia2, Cláudia Medina Coeli1 and Maria Lucia Fleiuss de Farias1

1 Service of Endocrinology and 2 Service of Radiology, University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil and 3 Service of Endocrinology, University Hospital Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil

(Correspondence should be addressed to Lenora Leão; Rua Pio Borges de Castro 5475 casa 1, CEP 22 793-325 Barra da Tijuca, Rio de Janeiro, Brasil; Email: lenora_leao{at}yahoo.com.br)

Background: There has been a growing interest in treating postmenopausal women with androgens. However, hyperandrogenemia in females has been associated with increased risk of cardiovascular disease.

Objective: We aimed to assess the effects of androgen replacement on cardiovascular risk factors.

Design: Thirty-seven postmenopausal women aged 42–62 years that had undergone hysterectomy were prospectively enrolled in a double-blind protocol to receive, for 12 months, percutaneous estradiol (E2) (1 mg/day) combined with either methyltestosterone (MT) (1.25 mg/day) or placebo.

Methods: Along with treatment, we evaluated serum E2, testosterone, sex hormone-binding globulin (SHBG), free androgen index, lipids, fibrinogen, and C-reactive protein; glucose tolerance; insulin resistance; blood pressure; body-mass index; and visceral and subcutaneous abdominal fat mass as assessed by computed tomography.

Results: A significant reduction in SHBG (P < 0.001) and increase in free testosterone index (P < 0.05; Repeated measures analysis of variance) were seen in the MT group. Total cholesterol, triglycerides, fibrinogen, and systolic and diastolic blood pressure were significantly lowered to a similar extent by both regimens, but high-density lipoprotein cholesterol decreased only in the androgen group. MT-treated women showed a modest rise in body weight and gained visceral fat mass relative to the other group (P < 0.05), but there were no significant detrimental effects on fasting insulin levels and insulin resistance.

Conclusion: This study suggests that the combination of low-dose oral MT and percutaneous E2, for 1 year, does not result in expressive increase of cardiovascular risk factors. This regimen can be recommended for symptomatic postmenopausal women, although it seems prudent to perform baseline and follow-up lipid profile and assessment of body composition, especially in those at high risk of cardiovascular disease.






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Copyright © 2006 by the Society of the European Journal of Endocrinology.