HORMONE REPLACEMENT IN MENOPAUSAL WOMEN

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In a study of body composition, sex steroids, GH and IGF-I in postmenopausal women whose body fat distribution and body fat mass independently range from lower (gynoid) to upper (android) distribution and from lower (lean) to higher (obese) percent at, we have found increased percent body fat and a more android body fat distribution with increasing age. There were independent inverse correlations of waist to hip ratio, but not of age or body mass index (BMI), with 12 hour pulsatile GH levels and GHRH-stimulated GH levels, suggesting an age-independent decrease in GH secretion attributable to android habitus. After oral estrogen treatment, there was increase in spontaneous GH secretion, but transdermal estrogens tended to decrease mean GH peak amplitude, with no change in 12 h mean GH secretion. Oral, but not transdermal estrogens significantly reduced basal and stimulated IGF-I. Another study examining estrogen-progestin co-therapy in older women has shown significant decreases in total cholesterol and LDL cholesterol with increases in HDL cholesterol, but no changes in triglycerides, BMI, or blood pressures. Non-significant decreases in urinary and serum calcium are consistent with a decrease in bone resorption. Results to date are consistent with potential beneficial effects of ERT on osteoporosis and coronary vascular disease in older women. New studies are being initiated to evaluate the transition from pre- to postmenopause and the effects of GHRH and estradiol on bone and muscle in osteoporotic women.