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Different effects of tibolone and continuous combined estrogen plus progestogen hormone therapy on sex hormone binding globulin and free testosterone levels--an association with mammographic density.
Hofling, Marie; Carlström, Kjell; Svane, Gunilla; Azavedo, Edward; Kloosterboer, Helenius; Von Schoultz, Bo.
Afiliación
  • Hofling M; Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden. marie.hofling@kbh.ki.se
Gynecol Endocrinol ; 20(2): 110-5, 2005 Feb.
Article en En | MEDLINE | ID: mdl-15823831
OBJECTIVE: To compare the effects of tibolone and continuous combined hormone therapy on circulating sex steroids and their binding proteins and their relationship to mammographic density. STUDY DESIGN: A prospective, double-blind placebo-controlled study. A total of 166 postmenopausal women were equally randomized to receive tibolone 2.5 mg, estradiol 2 mg/norethisterone acetate 1 mg (E2/NETA) or placebo. Serum analyses of sex steroids, insulin-like growth factor (IGF-I) and binding proteins and assessment of mammographic breast density were performed at baseline and after 6 months of treatment. RESULTS: Estrogens were markedly increased and androgens decreased by E2/NETA. In contrast, tibolone had only a minor influence on circulating estrogens. Sex hormone binding globulin (SHBG) levels were reduced by 50%, while levels of androgens increased. Baseline values of estrone sulfate (E1S), around 1.0-1.1 nmol/l, were increased to 44.7 nmol/l by E2/NETA and to only 1.7 nmol/l by tibolone (p < 0.001). Mammographic breast density displayed a negative correlation with age and body mass index and a positive association with SHBG. After 6 months there was also a negative correlation with levels of free testosterone. Conclusion We found that tibolone and E2/NETA caused distinct differences in estrogen/androgen status and blood levels of possible breast mitogens. The negative association between free testosterone and mammographic density could be a possible explanation for tibolone having less influence on the breast.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Mama / Menopausia / Terapia de Reemplazo de Estrógeno / Noretindrona Tipo de estudio: Clinical_trials / Risk_factors_studies Límite: Aged / Female / Humans / Middle aged Idioma: En Revista: Gynecol Endocrinol Asunto de la revista: ENDOCRINOLOGIA / GINECOLOGIA Año: 2005 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Mama / Menopausia / Terapia de Reemplazo de Estrógeno / Noretindrona Tipo de estudio: Clinical_trials / Risk_factors_studies Límite: Aged / Female / Humans / Middle aged Idioma: En Revista: Gynecol Endocrinol Asunto de la revista: ENDOCRINOLOGIA / GINECOLOGIA Año: 2005 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Reino Unido