(133) EFFECT OF TESTOSTERONE THERAPY ON MUSCULOSKELETAL PAIN IN PERIMENOPAUSAL AND POSTMENOPAUSAL WOMEN USING STANDARD HRT: A RETROSPECTIVE COHORT STUDY

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Abstract Introduction Declining oestrogen levels across the menopause transition are associated with musculo-skeletal (MSK) symptoms in 70% of peri- and postmenopausal women, the “Musculoskeletal Syndrome of Menopause, MSM” (Wright et al, 2024). Around 1 in 4 women experience severe symptoms including myalgia, arthralgia, and ligament and tendon pain, as well as long-term morbidities such as sarco- and osteopenia, osteoporosis, and progression of osteoarthritis. Testosterone production also falls with age, and testosterone deficiency is likely to contribute to musculoskeletal symptoms in mid- and late life. Prevention and management strategies include nutrition and exercise, and appropriate hormone therapy to replace the missing hormones. Objective To determine the proportion (%) of symptomatic women who reported an improvement in muscle and joint pain after starting testosterone. Methods A retrospective cohort study conducted at Newson Health, the UK’s largest specialist menopause clinic, between 1 January 2023 and 31 October 2023. All patients were asked to complete a modified version of the Greene Climacteric Scale (GCS) at each consultation, including a single item pertaining to MSK symptoms. Patients established on HRT (oestrogen with or without a progestogen) were included in the study if they initiated testosterone in the study period. Results The study included 797 patients with a mean age of 51.7 years (SD 5.1 years). The average follow-up time was 3 months. 454 women (57%) were prescribed Androfeme®, 335 (42%) were prescribed Testogel®, and 8 (1%) were prescribed Testim®. 672 women (84%) scored a 1,2 or 3 for “muscle and joint pains” at baseline. Overall, 373 of 672 symptomatic women (56%) reported an improvement in muscle and joint pains after 3 months. Excluding those with mild symptoms (score of 1), the effect of HRT was even more profound: 417 women (52%) scored moderately (score of 2) or severely (score of 3) on a 4-point Likert scale at baseline and of these 61% reported an improvement in their symptom score. Overall, symptom severity decreased from 2.31 at baseline was to 1.36 at follow-up (Likert scale 0-3). Conclusions This study demonstrates that a significant proportion of women with MSK symptoms despite standard HRT (oestrogen with or without a progestogen) experience an improvement in muscle and joint pain after 3 months testosterone therapy. These data highlight an urgent need for further research into the benefits of testosterone for alleviating MSK symptoms in perimenopausal and postmenopausal women. Disclosure No.

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