Clinical Observation Of Menopause Hormone Therapy On Postmenopausal Women With Different Levels Of TSH

Objective:To evaluate the endocrine hormone and metabolic status of postmenopausal women with different levels of thyroid stimulating hormone(TSH),and the changes of endocrine hormone and metabolic indexes after the application of menopause hormone therapy(MHT).Methods:A retrospective study was conducted including 2551 cases of perimenopausal syndrome who received MHT treatment in the gynecologic endocrinology clinic from September 2012 to September 2018.132 postmenopausal women were enrolled in this study.Baseline information including age,duration of menopause,height,weight,serum sex hormone levels,thyroid hormone levels,glucose and lipid metabolism indicators,and hot flashes of each patient were collected with informed consent at the initial diagnosis.According to the state of TSH level,the patients were divided into three groups:A(euthyroidism with low TSH group,n=89),B(euthyroidism with high TSH group,n=21)and C(subclinical hypothyroidism group,n=22).Three groups were treated with continuous regimen MHT,28 days were regarded as one treatment cycle.After 12 cycles of treatment,serum sex hormone levels,thyroid hormone levels,serum glucolipid metabolic index were reassessed.Results:The mean age(Mean±SD)of 132 postmenopausal women enrolled in the study was 50.93± 4.72 years.There was no significant difference in age,duration of menopause,body weight,BMI,incidence of hot flushes,FSH,E2,FT3,FT4,TG,TC,HDL-C,LDL-C,fasting plasma glucose,fasting insulin,and HOMA-IR index levels among the three groups at baseline(all p<0.05).After 12 cycles of treatment,the serum FSH level decreased and E2 level increased significantly in all three groups(all p<0.01).Compared with baseline,TSH level in group A increased,while that in group C decreased,and the difference was statistically significant(p<0.05).After 12 cycles of treatment,FT3 and FT4 levels decreased in group A,FT3 level decreased in group C with statistically significant differences(p<0.05),but the serum FT3 and FT4 concentrations were within the normal range.The serum TC,HDL-C levels and HOMA-IR index were decreased in group A,HOMA-IR index levels were decreased in group B,and TG levels were decreased in group C with statistically significant differences(p<0.05).Conclusions:For euthyroid postmenopausal women with different TSH levels,the application of MHT can effectively regulate sex hormone levels,metabolism of glucose and lipid.MHT does not affect thyroid function for postmenopausal women with euthyroidism and subclinical hypothyroidism,but it is still necessary to pay attention to the thyroid function during MHT treatment.