The effect of hormone replacement therapy on postmenopausal bone loss.
Eighty-four postmenopausal women who were randomly allocated to one of four groups, completed a 1 year follow-up. The first group (n = 20) received 0.625 mg/day conjugated estrogens cyclically (CE; 25 days/month). The second (n = 23) received 0.625 mg/day of CE continuously, and the third (n = 17) received 50 micrograms/day of transdermal 17 beta-estradiol cyclically (24 days/month). All these groups also received 2.5 mg of medroxiprogesterone acetate sequentially for the last 12 days of hormone replacement therapy, while the fourth group (n = 24) constituted a treatment-free control group. Dual photon absorptiometry was carried out before therapy and was repeated after 1 year. Serum calcium, phosphate and osteocalcine levels, and the urinary calcium/creatinine and hydroxyproline/creatinine ratios, were measured prior to treatment and 6 and 12 months thereafter. All treatment groups showed an increase in bone mineral content. This increase was higher in the continuous CE treatment group (4.4%, P less than 0.05) and in transdermal group (7.1%, P less than 0.01). Concomitant biochemical effects at 6 and 12 months, reduction in urine calcium and hydroxyproline, reduction in blood calcium, phosphate and osteocalcine, were compatible with the observed effects on bone mineral.
Castelo-Branco
C
C
Department of Gynaecology & Obstetrics, Hospital Clínic i Provincial, School of Medicine, University of Barcelona, Spain.
Martínez de Osaba
M J
MJ
Pons
F
F
González-Merlo
J
J
D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000097:blood / Q000652:urine; D004958:Estradiol / Q000494:pharmacology / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D004967:Estrogens / Q000494:pharmacology* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000378:metabolism; D010710:Phosphates / Q000097:blood / Q000652:urine
D004967:Estrogens; D010710:Phosphates; D004958:Estradiol; D002118:Calcium