Key takeaways:
- Postmenopausal girls prescribed tirzepatide had 35% higher weight reduction when taking concurrent hormone remedy.
- Estrogen might have a synergistic impact with GLP-1 therapies.
SAN FRANCISCO — Concurrent use of menopausal hormone remedy might increase the burden loss advantages of tirzepatide for postmenopausal girls with chubby or weight problems, researchers reported at ENDO 2025.
Regina Castaneda Hernandez
“We discovered an affiliation between hormone remedy use and higher weight reduction in postmenopausal girls,” Regina Castaneda Hernandez, MD, a analysis fellow within the division of ladies’s well being at Mayo Clinic, instructed Healio. “This was a retrospective research, so additional analysis is required to substantiate these findings. We can not overlook preclinical information displaying that there’s a potential synergistic impact between estrogen and GLP-1 signaling; nonetheless, we have to additional discover the underlying mechanisms. Postmenopausal girls symbolize a singular group because of their distinct hormonal and metabolic profiles, which contribute to the elevated cardiovascular threat noticed on this inhabitants; but, they continue to be underrepresented in pivotal weight problems pharmacotherapy trials.”
Ladies utilizing menopausal HT might lose extra weight with Zepbound than these not utilizing HT. Picture: Adobe Inventory
Tirzepatide (Zepbound, Eli Lilly), a twin GLP-1/GIP receptor agonist, has demonstrated sturdy efficacy in mixed-sex trial populations; nonetheless, its results for postmenopausal girls — and the way any results is likely to be modified by hormone remedy — haven’t been broadly explored, Castaneda Hernandez mentioned.
For the retrospective, real-world research, researchers analyzed digital well being information information from 120 postmenopausal girls prescribed tirzepatide for chubby or weight problems for at the very least 1 12 months; one-third have been taking menopausal HT and the remainder weren’t. Menopausal HT formulations included transdermal or oral estrogen, with or with out progesterone. Researchers used propensity rating matching primarily based on BMI, age at menopause, menopause sort and diabetes standing, matching every participant prescribed menopausal HT with two contributors not taking menopausal HT. The first endpoints have been whole physique weight reduction share at 3, 6, 9, 12 and 15 months and once more finally follow-up. Median follow-up was 18 months.
Maria Daniela Hurtado Andrade
Ultimately follow-up, the menopausal HT group skilled higher whole physique weight reduction in comparison with controls (19.18% vs. 13.96%; P = .002). By the final follow-up, the next proportion of ladies within the HT group achieved at the very least 20% whole physique weight reduction (45% vs. 23.8%; P = .02), at the very least 25% whole physique weight reduction (27.5% vs. 7.5%; P = .005) and at the very least 30% whole physique weight reduction (17.5% vs. 3.8%; P = .015) in contrast with these not taking HT.
“When menopause hormone remedy is suitable, combining it with weight problems pharmacotherapy might supply synergistic advantages by addressing each the hormonal adjustments of menopause and the organic drivers of extra adiposity,” Maria Daniela Hurtado Andrade, MD, PhD, an assistant professor of medication within the division of endocrinology, diabetes and metabolism at Mayo Clinic, instructed Healio in an e mail.
The researchers mentioned the info shouldn’t indicate that every one postmenopausal girls with chubby or weight problems obtain each therapies. Moreover, wholesome person bias and the alleviation of menopause-related signs with HT may have contributed to the higher weight reduction amongst girls taking HT.
“Menopausal HT ought to be prescribed primarily based on individualized scientific indications, sometimes for the administration of vasomotor signs and after a cautious evaluation of threat elements corresponding to age, time since menopause, and private or household historical past of breast most cancers or thromboembolism,” Andrade instructed Healio in an e mail.
Andrade mentioned the findings contribute to a rising physique of proof supporting tailor-made therapy approaches that tackle each hormonal and metabolic drivers of illness.
“As we transfer towards extra customized weight problems care, it’s important to acknowledge how organic intercourse and menopausal standing form therapy response,” Andrade instructed Healio in an e mail. “This strategy is not going to solely enhance particular person outcomes but additionally advance fairness in weight problems analysis and care supply.”
For extra info:
Regina Castaneda Hernandez, MD, will be reached at castaneda.regina@mayo.edu.
Maria Daniela Hurtado Andrade, MD, PhD, will be reached at hurtado.mariadaniela@mayo.edu.
Sources/Disclosures
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Castaneda R, et al. Summary RF09-03. Offered at: ENDO annual assembly; July 12-15, 2025; San Francisco.
Disclosures:
Hurtado Andrade studies receiving advisory charges from Novo Nordisk. Castaneda Hernandez studies no related monetary disclosures.
