Pathol Oncol Res. 2012 Apr;18(2):123-33.
"Insulin resistance and estrogen deficiency are concomitant disorders with mutual interrelationship.(...) a moderate or severe decrease in serum estrogen levels enhances the prevalence of insulin resistant states both in men and women."
"After menopause, hormone replacement therapy improves insulin sensitivity"
Diabetologia, June 1997, Volume 40, Issue 7, pp 843-849
"Oestrogen replacement therapy is associated with a decreased risk of cardiovascular disease in postmenopausal women. Patients with non-insulin-dependent diabetes mellitus (NIDDM) have an increased cardiovascular risk."
"In a double blind randomized placebo controlled trial we assessed the effect of oral 17 β -estradiol during 6 weeks in 40 postmenopausal women with NIDDM."
"Oestrogen replacement therapy improves insulin sensitivity in liver, glycaemic control, lipoprotein profile and fibrinolysis in postmenopausal women with NIDDM."
The Journal of Clinical Endocrinology & Metabolism
Volume 80, Issue 6
"We conclude that compared to the oral route, transdermal estrogen therapy is associated with a slight, but significant, improvement of insulin action on lipid metabolism. However, in the short term, the route of estrogen replacement therapy does not have a major impact on glucose metabolism in postmenopausal women."
Menopause. 2014 Jan 6.
"With regard to diabetes mellitus, which is a major risk factor
for CVD, CEE and transdermal estradiol seemed to have had
minimal effects on glucose metabolism and insulin resistance,
whereas MPA might have had a slightly adverse effect and MP
had no adverse effect.42 The PEPI Trial showed that CEE/MP,
unlike CEE/MPA, did not adversely affect carbohydrate metabolism.11 »
CEE = conjugated equine estrogen
MPA = medroxyprogesterone acetate
MP = micronized progesterone
CVD = cardiovascular disease
"A recent evaluation of the E3N cohort (E3N is the French
component of the European Prospective Investigation into Cancer
and Nutrition Study) showed that, overall, the incidence of newonset
diabetes among nearly 64,000 postmenopausal women
followed for an average of more than 10 years was lower among
HT users than among nonusers (HR, 0.82).43 In France, the
transdermal route of estrogen administration is used far more often
than the oral route. For women in this study who used transdermal
estrogen plus a progestogen, MP, in a head-to-head comparison
with synthetic progestins, had the lowest HR for new-onset diabetes
(0.67).43 »
This suggests MPA should be avoided.
Climacteric. 2012 Apr;15 Suppl 1:11-7
"Micronized progesterone has also been shown not to increase the risk of venous thromboembolism and further reduced the incidence of new-onset diabetes when combined with transdermal estrogen."
Maturitas. 2015 Mar 9.
"When different progestogens were analyzed, transdermal estrogens with progesterone (HR 0.67, 95% CI, 0.54–0.84) and oral estrogens with NETA (HR 0.44, 95% CI, 0.26–0.75) or cyproterone acetate (HR 0.44, 95% CI, 0.23–0.85) were the only formulations that significantly lowered diabetes risk (oral estrogens with progesterone could not be analyzed because of too few women in that group) [53]."
NETA = norethisterone acetate (mildly androgenic)
Lipids Health Dis. 2012 Oct 9;11:133.
"The effects of intranasal and percutaneous estradiol were similar, regardless of the addition of progesterone. Similarly, for the overall group of 86 women, micronized progesterone did not alter the response to E2. Blood pressure, glucose, insulin, HDL-c, triglycerides, and usCRP remained constant with or without micronized progesterone."
Hum Reprod. 2002 Mar;17(3):825-9.
"We examined metabolic parameters in cohorts of women with and without subcutaneous estrogen therapy with concomitant supra-normal concentrations of estradiol (SE)."
"Women with SE have similar triglyceride and HDL cholesterol levels but lower LDL cholesterol concentrations compared with post-menopausal women not taking ERT. The observations that the SE group showed reduced fasting insulin and WHR suggest that supra-normal circulating concentrations of estradiol, delivered subcutaneously, may beneficially influence insulin metabolism."
WHR = waist-hip ratio
Lancet. 1999 Aug 7;354(9177):487-8.
"C-reactive protein concentrations as a marker of inflammation predicts vascular risk and is raised in type-2 diabetes. In a 6-month double-blind placebo controlled trial, a combination of transdermal oestradiol (...) with continuous oral norethisterone (...) significantly reduced C-reactive protein concentrations in postmenopausal women with type-2 diabetes."
Drugs Aging. 2000 Nov;17(5):399-410.
"Unopposed estradiol therapy seems to have a favourable effect on lipid profile and glucose tolerance whereas addition of a progestogen may attenuate these favourable metabolic changes."
"Present evidence suggests that short term unopposed oral estradiol therapy has a beneficial effect on glucose homeostasis, lipid profile"
"Accordingly, it may be hypothesised that HRT in women with diabetes mellitus may be at least as beneficial as in women without diabetes mellitus."
Atherosclerosis. 2003 May;168(1):123-9.
"Both oral and transdermal E2 significantly reduced fasting glucose."
Int J Oncol. 2011 Dec;39(6):1443-53.
"Estrogen treatment triggered the loss of body fat, induced insulin sensitivity, suppressed tumor growth, reduced growth factors and improved hepatic steatosis."
I personally take a high dose of micronized progesterone daily and a high dose of estradiol parenterally (injection), with levels of estradiol in the range of 1,000-4,000 pg/ml.
My glucose was tested several times and came back normal and Hb1Ac which gives an indication of glucose levels over many months, also came back normal. Insulin levels are normal and IGF-1 is low.
