Effects of Ultra-Low-Dose Estrogen Therapy on Muscle and Physical Function in Older Women

Objectives: To determine the effects of ultra‐low‐dose hormone therapy on muscle mass and physical function in community‐dwelling women. Design: Double‐blind, placebo‐controlled trial. Setting: Clinical research center in Connecticut. Participants: Healthy, community‐dwelling women aged 65 and older (n=167). Intervention: Eligible women were randomly assigned to treatment with 0.25 mg 17‐beta estradiol or placebo for 36 months. All women (estradiol or placebo) with an intact uterus received micronized progesterone 100 mg/d for 2 weeks every 6 months. All participants received 1,300 mg elemental calcium with 1,000 IU vitamin D per day. Measurements: Appendicular skeletal muscle mass (ASM), lean body mass (LBM), and percentage body fat were measured using dual x‐ray absorptiometry. Sarcopenia was defined as skeletal muscle mass (ASM/height2) 2 standard deviations or less than young, healthy reference population mean. Physical activity (Physical Activity Scale in the Elderly (PASE)) and performance were measured. Serum estrone, estradiol, and sex hormone–binding globulin were measured. Results: The prevalence of sarcopenia at baseline was 13%. There were no baseline differences between groups except for PASE score and chair rise time, in which the estrogen group had better performance. No changes in ASM, LBM, percentage of body fat, or physical performance were found after 3 years of estrogen therapy. Conclusion: Sarcopenia was present in 13% of this group of community‐dwelling, postmenopausal older women. Ultra‐low‐dose estrogen therapy neither improves nor harms ASM. Similarly, no changes in body fat or physical performance were detected.