A randomized trial on the effect of oral combined estradiol and drospirenone on glucose and insulin metabolism in healthy menopausal women with a normal OGTT

Abstract Background Menopause is often associated with a central accumulation of body fat. This provokes insulin resistance. The resulting hyperinsulinemia may enhance the development of diabetes, cardiovascular disease and breast cancer. Long term studies indicate that menopausal hormone therapy (MHT) reduces insulin resistance. To broaden the knowledge on the mechanisms behind the influence of MHT on glucose homeostasis we focused on direct short-term effects of MHT with oral combined estradiol and drospirenone, on glucose and insulin metabolism in healthy postmenopausal women. Methods This randomized, placebo-controlled study recruited 80 healthy postmenopausal women. Women were randomized to treatment with estradiol 1 mg continuously combined with drospirenone 2 mg or placebo for 6–8 weeks. All participants underwent an oral glucose tolerance test (OGTT) before and after the treatment period. Glucose, insulin, fructosamine and C-peptide levels were measured in serum before and 30, 60, 90, 120 and 150 min after a 75 gram oral glucose challenge. Results After intervention significantly higher glucose levels at 120 min (p  A significantly lower insulin peak serum level (p  Conclusion This double-blind randomized study (EC/2008/694) indicates that treating healthy, postmenopausal women with 1 mg estradiol continuously combined with 2 mg drospirenone, significantly decreases peak insulin levels and increases peak glucose levels during an OGTT compared to placebo. These glucose levels remained within the normal range.