Sahar Swidan, Pharm.D.

Sahar Swidan, Pharm.D.

BCPS, ABAAHP, FAARFM, FACA

PHRT Benefits and Treatment Options

Treatment Options with Personalized Hormone Replacement Therapy (PHRT)

Hormone Replacement Therapy (HRT) can be beneficial when started close to the perimenopause to early menopause stage. There’s a notable increase in metabolic issues and Type-2 diabetes during these stages, which can be a risk factor for heart disease in women.

Younger women are less likely than men to develop type 2 diabetes.  After menopause, the trend reverses dramatically and women are at higher risk of diabetes due to declining levels of estrogen, specifically estradiol, which exerts specific actions on the pancreas and insulin biosynthesis and secretion.

Clinical and experimental data from research done at University Hospital/Diabetes Center and University of Geneva Medical School, Geneva, Switzerland indicate a beneficial effect of estrogen on energy and glucose homeostasis associated with improved insulin sensitivity.

Dr. Sandra Handgraaf noted: “A number of scientists are working on the effect of estrogen on pancreatic insulin-producing cells.  But its effect on glucagon-producing cells, another hormone regulating blood sugar, had never been explored before… Besides their pivotal role in sexual development and reproduction, estrogen prevent the occurrence of visceral obesity, insulin resistance, and glucose intolerance in women.”

Study leader Jacques Philippe, MD, a Harvard University/Mass General Hospital-trained endocrinologist, said: “It is important to remember hormonal substitution, when taken at the beginning of menopause and for a few years only, does not cause any particular risk of cardiovascular events.”

The study concluded that a woman receiving hormone replacement therapy is up to 35 percent less likely to develop type 2 diabetes.

The full study is available via JCI Insight 2018;3(7):e98569.