Menopausal hyperinsulinism and hypertension - new approach

Area of Science:

• Endocrinology
• Cardiovascular Health
• Metabolic Health

Background:

• Menopause is associated with hormonal changes, metabolic alterations like hyperinsulinism, and cardiovascular risk factors such as hypertension.
• Hormone therapy aims to alleviate menopausal symptoms and mitigate associated health risks.

Purpose of the Study:

• To evaluate the efficacy of combined estradiol (E2) and drospirenone (DRSP) in managing menopausal symptoms, hyperinsulinism, and grade I hypertension in normal-weight women.
• To assess the impact of E2/DRSP therapy on lipid profiles, glucose metabolism, hormonal status, and blood pressure.

Main Methods:

• A 12-month prospective study involving 133 menopausal women (mean age 51.82 years) treated with E2 1 mg and DRSP 2 mg daily.
• Measurements included lipid profiles, fasting glucose, oral glucose tolerance tests (OGTT) for insulin secretion (HOMA, AUC), hormonal levels (FSH, LH, E2, T, SHBG), and 24-hour ambulatory blood pressure monitoring.

Main Results:

• E2/DRSP therapy significantly improved lipid profiles, decreasing total cholesterol, LDL, and ApoB, while increasing HDL and ApoA.
• Significant reductions were observed in insulin area under the curve (AUC) and HOMA scores, indicating improved insulin sensitivity.
• Hormonal analysis showed decreased FSH and LH, and increased E2 levels. 24-hour blood pressure also significantly decreased.

Conclusions:

• Combined E2/DRSP therapy is a suitable treatment option for menopausal women experiencing typical symptoms, hyperinsulinism, and grade I hypertension.
• The therapy demonstrates beneficial effects on metabolic parameters, cardiovascular risk factors, and hormonal balance in this population.