Carbohydrate metabolism during hormonal substitution therapy

Area of Science:

• Endocrinology
• Reproductive Medicine
• Metabolic Health

Background:

• Oestrogens and progestogens can affect glucose tolerance, particularly progestogens with androgenic properties.
• Dydrogesterone is a common progestogen used with oestrogen therapy for menopausal symptoms.
• Limited data exist on dydrogesterone's specific effects on carbohydrate metabolism.

Purpose of the Study:

• To investigate the effects of dydrogesterone, as an adjunct to oestrogen therapy, on carbohydrate metabolism in post-menopausal women.
• To assess changes in glucose tolerance and insulin response during combined hormone therapy.

Main Methods:

• A study involving 20 healthy post-menopausal women.
• Treatment involved equine oestrogens followed by cyclic addition of dydrogesterone.
• Oral glucose tolerance tests were conducted before and after each treatment phase.

Main Results:

• Dydrogesterone administration resulted in a minor, non-statistically significant increase in blood insulin levels.
• The observed insulin response was comparable to that of endogenous progesterone.
• No significant impairment of glucose tolerance was detected with the addition of dydrogesterone.

Conclusions:

• Dydrogesterone, when used cyclically with equine oestrogens, does not significantly alter glucose tolerance or insulin response.
• The metabolic effects of dydrogesterone are clinically insignificant, similar to endogenous progesterone.
• This suggests dydrogesterone is a safe progestogen option regarding carbohydrate metabolism in hormone therapy.