Longitudinal changes over three years in sex steroid hormone levels in women aged 70 years and over

Abstract

Objective: Sex steroid levels in women vary with increasing age from the age of 70 years (70+). Whether this reflects change within individuals with age or a survival advantage is not known. This study aimed to determine the stability of circulating sex steroids and SHBG over time in individual women aged 70+.

Design: A prospective cohort study.

Participants: 400 women, aged 70+ not using any sex steroid, anti-androgen/oestrogen or glucocorticoid therapy.

Main outcome measurements: Sex steroid concentrations, measured by liquid chromatography-tandem mass spectrometry and sex hormone-binding globulin (SHBG) by immunoassay, in paired blood samples drawn 3 years apart and analysed together.

Results: 400 women, median (IQR) age 78.0 (8.6) years, were included in the analysis. Mean testosterone concentrations were statistically significantly higher in follow-up samples compared with baseline. The change was modest (mean change 31 pmol/L, 95% confidence interval (CI) 2.4-59.8; p = .034), and an increase was not observed in all women. There was a statistically significant decline in mean body mass index (mean change -0.4 kg/m2 , 95% CI 0.6 to -0.3; p < .001) and a significant increase in the mean serum SHBG concentration (mean change 4.0 nmol/L, 95% CI 2.7-5.4; p < .001). The change observed in testosterone was not explained by the observed change in SHBG. There was no significant change in the mean oestrone or dehydroepiandrosterone concentration.

Conclusions: Testosterone concentrations in women aged 70+ were more likely to increase than decrease. Whether increasing testosterone concentrations in older women confer a survival advantage needs investigation.

Trial registration: ClinicalTrials.gov NCT01038583.

Keywords: Sex steroids in women; hormones older women; postmenopause.

Conflict of interest statement

CONFLICT OF INTEREST

Dr Davis reports having received honoraria from Besins Healthcare, BioFemme and Pfizer Australia and has been a consultant to Mayne Pharmaceuticals, Roche Pharmaceuticals, Lawley Pharmaceuticals, Southern Star Research and Que Oncology. Dr Handelsman has received institutional grant funding (but no personal income) for investigator-initiated clinical testosterone pharmacology studies (Lawley, Besins Healthcare) and has provided expert testimony to anti-doping and professional standards tribunals and testosterone litigation.

© 2021 John Wiley & Sons Ltd.

Figures

FIGURE 1:

Flow chart of recruitment to the study