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Hormone Therapy: No Big Whoop for Muscle Mass

— Meta-analysis looked at estrogen-only and combination menopausal hormone regimens

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Among postmenopausal women, use of menopausal hormone therapy wasn't associated with muscle retention, a meta-analysis concluded.

With data pooled from 12 randomized controlled trials including nearly 4,500 women, there was no significant difference in lean body mass (LBM) lost for those on versus not on hormone therapy (mean difference -0.13 lbs, 95% CI -0.11 to 0.4 lbs), reported Parminder Raina, PhD, of McMaster University in Canada, and colleagues. This didn't change when the outcome was controlled for the age of menopause onset, type of LBM used, duration of follow-up, nor the type or dose of hormone therapy provided.

"This finding... is unlikely to be clinically relevant for the average postmenopausal woman," the group wrote in .

"It is reported that women older than 50 years lose approximately 1% of muscle mass annually," they continued. "At this rate, it would take approximately 66 years for a woman of average height and LBM to become sarcopenic according to the cutoff of 7.4 kg/m2 recommended by the European Working Group on Sarcopenia."

On the other hand, Raina's group pointed out that, based upon the findings of their meta-analysis, hormone therapy for menopausal women could lengthen the amount of time they are sarcopenia-free to roughly 80 years of age. But when weighing the risks of hormone therapy use -- some of which include risk for and venous thromboembolism -- against the benefits, maintaining muscle mass and increasing sarcopenia-free time isn't likely to factor in as an important benefit.

"Also, sarcopenia in postmenopausal women is associated most with physical inactivity, reduced protein intake, and oxidative stress occurring at the time of menopause, but not directly with menopause itself," the researchers noted. "It is possible this is why [hormone therapy] does not appear to offer any benefit to retaining muscle after menopause, despite the decline in muscle mass during this time."

These findings could however be of potential benefit to women with low muscle mass prior to menopause, and future research should assess these outcomes in this particular population, the group suggested.

The systematic review and meta-analysis included trials whose participants were postmenopausal women 50 years or older. Those receiving hormone therapy were on either estrogen-only (seven trials) or combination estrogen-progesterone hormones (15 trials) compared with women on placebo or nothing at all. Including a combination of continuous dosage and cyclical dosage regimens, the treatment duration among the included studies ranged up to 8 years, with dosing ranging from 9 to 25 days per month.

"Despite the limitations of the literature, this study highlights the consistently null results in studies investigating [hormone therapy] and retention of muscle mass," the group underscored. Raina and colleagues suggested that researchers look elsewhere for interventions to help older women retain muscle mass.

  • author['full_name']

    Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

Raina reported holding a Tier 1 Canada Research Chair in Geroscience and the Raymond and Margaret Labarge Chair in Research and Knowledge Application for Optimal Aging. No other disclosures were reported.

Primary Source

JAMA Network Open

Javed AA, et al "Association between hormone therapy and muscle mass in postmenopausal women" JAMA Netw Open 2019; DOI: 10.1001/jamanetworkopen.2019.10154.