绝经后的激素取代疗法会不会影响运动表现？

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Does post-menopausal hormone replacement therapy affect exercise performance?Stathokostas, L., Kowalchuk, J.M., Petrella, R.J., and Paterson, D.H.
2008. Maximal and submaximal aerobic fitness in postmenopausal women: influence of hormone-replacement therapy. Appl. Physiol. Nutr. Metab. 33: 922-928.
Originally published in the CSEP member newsletter, Communiqué, February 2009.
An important component influencing exercise tolerance is the ability of the cardiovascular system to deliver oxygen to exercising muscles. In this regard, the role of the physiological effects of hormone replacement (HRT) use, specifically estrogen, on exercise tolerance has received attention recently. This stems from observations of the physiological differences in many variables related to cardiovascular function and the regulation of blood flow resulting from lack of estrogen when comparing post-menopausal women to pre-menopausal women. Although HRT is no longer prescribed for cardiovascular protection, current practices of HRT prescription are related to the relief of unpleasant symptoms associated with menopause and for osteoporosis protection. Therefore, understanding the effects of HRT on the systems contributing to aerobic power are important to women´s cardiovascular health. As such, it is of interest to exercise professionals to determine if the use of HRT affects the exercise response.
A review of the literature describing the effect of HRT on aerobic power yields no definitive consensus. A consensus is confounded by comparisons in the literature where the samples differ by age, or for groups of women characterized by different physical activity levels (sedentary or endurance trained groups), the presence of disease (healthy or groups at risk for coronary artery disease) or short versus long-term HRT users.
One group of women that had not been adequately studied are post-menopausal women who are moderately active. Our study (1) describes two groups of post-menopausal women aged 53 to 74 years (average age of 62 years), 20 using HRT and 20 women not using HRT. Our volunteers were recruited from an older-adult based exercise and research facility where the women attended three one-hour exercise sessions per week. To study the effects of HRT on aerobic power in post-menopausal women we compared the performances on a maximal cycle ergometer exercise. We assessed variables such as maximal aerobic power (VO2peak), maximal heart rate, blood pressure, as well as anthropometric measurements.
The results of this study showed no difference in aerobic power of healthy active women taking chronic HRT (mean VO2peak 22.9 ml/kg.min) versus healthy active women not using HRT (mean VO2peak 22.0 ml/kg.min). In our study, we considered factors such physical activity levels, the type of hormone replacement therapy used, and the duration of hormone therapy use. There were no differences in the exercise response in our study based on these variables.
Whereas evidence exists that HRT has an impact on certain components of cardiovascular physiology (i.e. blood flow to exercising muscles), it does not appear that these cardiovascular effects translate into having an effect on functional capacity as measured by maximal aerobic power in healthy active post-menopausal women. This study was not a randomized trial, and the sample size may have influenced the ability to detect significant differences between HRT users and non-users, however, our results support the concept that potential benefits of HRT on cardiovascular function may not be additive to the potential benefits of exercise participation.
This article is a summary of an article accepted for publication in Applied Physiology, Nutrition and Metabolism. If you intend citing any information in this article, please consult the original article and cite that source. This summary was written by Dr. Liza Stathokostas and Dr. Don Paterson for the Canadian Society for Exercise Physiology and it is endorsed by the CSEP Knowledge Translation Committee. The CSEP Knowledge Translation Committee supports the translation of research-based knowledge for the practical application of improving the heath of Canadians through the publication of this article.


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