Читать книгу Metabolic Syndrome Consequent to Endocrine Disorders - Группа авторов - Страница 24

Because estrogen antagonizes the metabolic actions of GH on the liver it should be replaced by a non-oral route in women with hypopituitarism [25]. For hypopituitary women with GHD, estrogen replacement will worsen GHD state and for those taking oral estrogen during GHRT, it will reduce therapeutic benefit of GH [23–25]. In a single survey, only 19% of GHD women received estrogens via transdermal route [23]. On the other hand, oral estrogen replacement substantially increased the dose (55–70%) and cost of GHRT compared to transdermal patches (20–30%) [25]. When contraceptives are prescribed instead of replacement doses the waste is even greater [96].

Testosterone and GH exert similar effects on body composition and physical function. They also act together in augmenting each other’s effects. In men with hypopituitarism, concomitant GH and testosterone replacement are needed to achieve optimal effects. The adverse effects are however more frequent when co-administered and for this reason stepwise introduction of GH and testosterone replacement with gradual dose adjustment is advised [25].