EFFECTS OF HORMONE REPLACEMENT THERAPY ON WEIGHT, BODY-COMPOSITION, FAT DISTRIBUTION, AND FOOD-INTAKE IN EARLY POSTMENOPAUSAL WOMEN - A PROSPECTIVE-STUDY

Objective: To evaluate the effects of hormone replacement therapy (HRT ) on body weight and composition, fat distribution, and food intake in women entering the climacteric. Design: Prospective clinical study. S etting: Outpatient menopause clinic at a tertiary medical center. Part icipants: Sixty-three early postmenopausal women (44 to 54 years old) were prospectively studied for 1 year. They consisted of two groups: g roup A, 34 subjects who initiated continuous estrogen and progestin tr eatment (daily oral conjugated estrogen 0.625 mg and medroxyprogestero ne acetate 2.5 mg), and group B, 29 women who refused hormonal therapy and served as controls. The age, menopausal status, initial anthropom etric measurements (weight, body mass index [BMI], fat mass, and waist -to-hip girth ratio), and daily food intake (total caloric intake and food composition) were similar in both groups. Interventions: Anthropo metric measurements were performed before commencement of HRT use and after 12 months. Main Outcome Measures: Anthropometric measurements in cluded BMI, waist-to-hip girth ratio, and body composition (the percen tage of body fat and water) estimated by means of infrared interactanc e. Daily food intake was also recorded. Results: The body weight and f at mass increased significantly in both the treatment (73.22 +/- 2.01 [mean +/- SE] to 75.57 +/- 1.12 kg) and the control group (71.45 +/- 3 .11 to 73.51 +/- 1.23 kg). However, a significant shift from gynoid to android fat distribution was observed only in the control group (wais t-to-hip ratio shifted from 0.80 +/- 0.01 to 0.85 +/- 0.01), whereas n o significant change was observed in the treatment group (0.81 +/- 0.0 1 to 0.82 +/- 0.01). Caloric and macronutrient intake did not change i n either group. Conclusions: These results indicate that continuous da ily estrogen and progestin replacement therapy neither prevents nor in creases early postmenopausal weight gain and fat accumulation. However , it does minimize the shift from gynoid to android fat distribution.