A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women

Background: Allostatic load (AL), a measure of physiologic dysregulation across multiple systems, has been shown to increase as women age and go through menopause. While hormone use has been shown to help with the relief of menopausal symptoms, it is not clear whether the use of hormone replacement...

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Main Authors: Pamela Lamisi Alebna, Joaquin Ignacio Armendano, Nasim Maleki
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Aging and Health Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S2667032124000349
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author Pamela Lamisi Alebna
Joaquin Ignacio Armendano
Nasim Maleki
author_facet Pamela Lamisi Alebna
Joaquin Ignacio Armendano
Nasim Maleki
author_sort Pamela Lamisi Alebna
collection DOAJ
description Background: Allostatic load (AL), a measure of physiologic dysregulation across multiple systems, has been shown to increase as women age and go through menopause. While hormone use has been shown to help with the relief of menopausal symptoms, it is not clear whether the use of hormone replacement therapy and hormonal contraceptives in the perimenopausal period has an impact on alleviating allostatic load in aging women. Methods: We conducted a target trial emulation to estimate the on-treatment (i.e., per-protocol) effect of hormone replacement therapy or hormonal contraceptives use on AL score evolution over time. We included in our analysis 2,199 women from the SWAN cohort that were followed-up between 1996 and 2005. To estimate the effect of the continuous use of hormone replacement therapy or hormonal contraceptives on AL score evolution over the follow-up period we used marginal structural models estimated using inverse probability weighting. Results: The mean AL score at baseline was 2.45 ± 1.85 (Mean ± SD). The AL score remained relatively stable in women that never used hormone replacement therapy or hormonal contraceptives, with an average increase of 0.014 ± 0.011 (Mean ± SE) per year, whereas in women that used hormone replacement therapy or hormonal contraceptives continuously, the AL score increased, on average 0.087 ± 0.014 (Mean ± SE) per year. We did not find conclusive evidence to support that continuous use of hormone replacement therapy or hormonal contraceptives modifies the AL score trajectory (mean difference between trends = 0.073; CI95%: -0.027, 0.173; P = 0.1538). Conclusion: Continuous use of hormone replacement therapy or hormonal contraceptives during the menopause transition period was not associated with increased allostatic load. The findings suggest continuous use of hormone therapy as a treatment for perimenopausal symptoms in aging women doesn't confer a risk for increased allostatic load.
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spelling doaj-art-e814a0689bc64183afa5a3b62e9c56072025-08-20T02:38:49ZengElsevierAging and Health Research2667-03212025-03-015110021310.1016/j.ahr.2024.100213A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal womenPamela Lamisi Alebna0Joaquin Ignacio Armendano1Nasim Maleki2Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Internal Medicine, Rutgers/Robert Wood Johnson Barnabas Health, Jersey City Medical Center, USANational University of the Center of the Province of Buenos Aires, Tandil, BA, ArgentinaDepartment of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Corresponding authorat: Massachusetts General Hospital, Suite 101E, Building 120, Second Avenue, Charlestown, MA, 02129, USA.Background: Allostatic load (AL), a measure of physiologic dysregulation across multiple systems, has been shown to increase as women age and go through menopause. While hormone use has been shown to help with the relief of menopausal symptoms, it is not clear whether the use of hormone replacement therapy and hormonal contraceptives in the perimenopausal period has an impact on alleviating allostatic load in aging women. Methods: We conducted a target trial emulation to estimate the on-treatment (i.e., per-protocol) effect of hormone replacement therapy or hormonal contraceptives use on AL score evolution over time. We included in our analysis 2,199 women from the SWAN cohort that were followed-up between 1996 and 2005. To estimate the effect of the continuous use of hormone replacement therapy or hormonal contraceptives on AL score evolution over the follow-up period we used marginal structural models estimated using inverse probability weighting. Results: The mean AL score at baseline was 2.45 ± 1.85 (Mean ± SD). The AL score remained relatively stable in women that never used hormone replacement therapy or hormonal contraceptives, with an average increase of 0.014 ± 0.011 (Mean ± SE) per year, whereas in women that used hormone replacement therapy or hormonal contraceptives continuously, the AL score increased, on average 0.087 ± 0.014 (Mean ± SE) per year. We did not find conclusive evidence to support that continuous use of hormone replacement therapy or hormonal contraceptives modifies the AL score trajectory (mean difference between trends = 0.073; CI95%: -0.027, 0.173; P = 0.1538). Conclusion: Continuous use of hormone replacement therapy or hormonal contraceptives during the menopause transition period was not associated with increased allostatic load. The findings suggest continuous use of hormone therapy as a treatment for perimenopausal symptoms in aging women doesn't confer a risk for increased allostatic load.http://www.sciencedirect.com/science/article/pii/S2667032124000349AgingAllostatic loadMenopauseHormone therapy
spellingShingle Pamela Lamisi Alebna
Joaquin Ignacio Armendano
Nasim Maleki
A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
Aging and Health Research
Aging
Allostatic load
Menopause
Hormone therapy
title A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
title_full A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
title_fullStr A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
title_full_unstemmed A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
title_short A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
title_sort longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women
topic Aging
Allostatic load
Menopause
Hormone therapy
url http://www.sciencedirect.com/science/article/pii/S2667032124000349
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