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Hormone therapy and insulin resistance in non-diabetic postmenopausal women: a systematic review and meta-analysis
Journal article   Peer reviewed

Hormone therapy and insulin resistance in non-diabetic postmenopausal women: a systematic review and meta-analysis

Tanya Li, Nathan S Jiang, Julia Kaskey, Peter F Schnatz and Matthew Nudy
Climacteric : the journal of the International Menopause Society, v 28(6), pp 673-681
Dec 2025
PMID: 40531213

Abstract

Estrogen Replacement Therapy - methods Estrogens - administration & dosage Female Humans Insulin Resistance Middle Aged Postmenopause Progestins - administration & dosage Randomized Controlled Trials as Topic
Menopause increases the risk of insulin resistance and cardiometabolic diseases. This study summarizes the effects of hormone therapy (HT) on insulin resistance in non-diabetic postmenopausal women. The study analyzed randomized controlled trials (1998-2024) that assessed the impact of HT on insulin resistance using homeostasis model assessment of insulin resistance (HOMA-IR) in non-diabetic postmenopausal women. Raw mean differences (RMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analysis compared estrogen alone (E alone) and estrogen plus progestogen (E + P) to placebo. Seventeen randomized controlled trials with 5772 women (3644 on HT: E alone [  = 1259] or E + P [  = 2385]; 2128 on placebo) were included. The weighted mean (standard deviation) age was 56.91 (5.95) years, with treatment lasting 8 weeks to 3 years. HT significantly reduced HOMA-IR (RMD = -0.24 [-0.32 to -0.16],  < 0.001, = 60.3%). Subgroup analysis showed reductions in both E alone (RMD = -0.42 [-0.55 to -0.29],  < 0.001, = 35%) and E + P (RMD= -0.14 [-0.23 to -0.04],  = 0.005, = 13.7%) compared to placebo. HT significantly lowers insulin resistance in healthy, non-diabetic postmenopausal women, with E alone yielding greater reductions than combination therapy.

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#5 Gender Equality
#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Obstetrics & Gynecology
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