Menopause, Estrogens, and Glucose Homeostasis in Women.

Randomized trials suggest that menopausal hormone therapy (MHT) prevents type 2 diabetes. Still, the mechanisms of these antidiabetic effects are a matter of controversy. This chapter provides an analysis of epidemiological and clinical evidence and proposes a mechanism for the effect of menopause and MHT on type 2 diabetes development and prevention. It discusses the beneficial role of estradiol on glucose homeostasis that is lost at menopause and improved by MHT, which delays type 2 diabetes. This chapter aims to reconcile differences among studies of the effect of menopause and MHT formulations on type 2 diabetes and argues that discrepancies arise from physiological differences in methods used to assess glucose homeostasis.