Effect of menopause and different combined estradiol-progestin regimens on basal and growth hormone-releasing hormone-stimulated serum growth hormone, insulin-like growth factor-1, insulin-like growth factor binding protein (IGFBP)-1, and IGFBP-3 levels

Fertil Steril. 1999 Feb;71(2):261-7. doi: 10.1016/s0015-0282(98)00432-4.


Objective: To determine the effects of menopause and three different formulations of E2 plus medroxyprogesterone acetate on serum concentrations of basal and growth hormone-releasing hormone (GHRH)-stimulated growth hormone (GH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein (IGFBP)-1, IGFBP-3, insulin, and C peptide.

Design: Prospective, controlled trial.

Setting: Menopausal outpatient clinic at an academic tertiary care hospital.

Patient(s): Nineteen postmenopausal women with different menopausal ages. Seventeen premenopausal women were included as controls.

Intervention(s): Oral estrogen (E2 valerate, 2 mg/d) or transdermal estrogen (50-microg or 100-microg E2 patch) was administered for 8 weeks. Medroxyprogesterone acetate (5 mg/d) was administered during weeks 3, 4, 7, and 8 of each protocol. Blood samples were collected before treatment and after the completion of each protocol from postmenopausal women, and on cycle days 6-8 from premenopausal women.

Main outcome measure(s): Levels of GH, IGF-1, IGFBP-1, IGFBP-3, insulin, and C peptide.

Result(s): Basal GH levels were negatively correlated with age in premenopausal women but not in postmenopausal women. The area under the GHRH-induced GH curve decreased in older postmenopausal women after the oral estrogen protocol. Levels of IGF-1 diminished after the oral E2 protocol in postmenopausal women.

Conclusion(s): The administration of oral, but not transdermal, E2 plus medroxyprogesterone acetate at the usual clinical doses used in postmenopausal women decreased IGF-1 levels and the response of GH to GHRH in older women. No substantial changes were detected in IGFBP-1, IGFBP-3, insulin, or C peptide levels.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Basal Metabolism
  • Drug Therapy, Combination
  • Estradiol / therapeutic use
  • Female
  • Growth Hormone-Releasing Hormone / pharmacology*
  • Hormone Replacement Therapy*
  • Human Growth Hormone / blood
  • Humans
  • Insulin-Like Growth Factor Binding Protein 1 / blood
  • Insulin-Like Growth Factor Binding Protein 3 / blood
  • Insulin-Like Growth Factor I / metabolism
  • Medroxyprogesterone Acetate / therapeutic use
  • Middle Aged
  • Postmenopause / physiology*
  • Premenopause / physiology*
  • Progesterone Congeners / therapeutic use
  • Prospective Studies


  • Insulin-Like Growth Factor Binding Protein 1
  • Insulin-Like Growth Factor Binding Protein 3
  • Progesterone Congeners
  • Human Growth Hormone
  • Estradiol
  • Insulin-Like Growth Factor I
  • Growth Hormone-Releasing Hormone
  • Medroxyprogesterone Acetate