Longitudinal evaluation of perimenopausal vertebral bone loss: effects of a low-dose oral contraceptive preparation on bone mineral density and metabolism.
OBJECTIVE
To characterize the pattern of biochemical markers of bone metabolism and vertebral bone mineral density in eumenorrheic and oligomenorrheic perimenopausal women and to assess the effects of a combined oral contraceptive (OC) preparation on bone mass and metabolism.


METHODS
Bone biochemical markers and vertebral bone density were evaluated in a longitudinal 2-year follow-up study conducted in healthy, normally menstruating perimenopausal women, perimenopausal oligomenorrheic women, and age-matched oligomenorrheic OC-treated women (20 micrograms ethinyl estradiol [E2] plus 0.15 mg desogestrel) (n = 27 in each group). The results were analyzed by factorial or repeated-measures analysis of variance, as appropriate.


RESULTS
During our observation period, there were no significant modifications in menstrual cycle, plasma FSH and E2 levels, biochemical markers of bone turnover, and vertebral bone density in normal women. Conversely, oligomenorrheic women showed an increase in the cycle length with a concomitant decrease of plasma E2 and a corresponding rise in circulating plasma FSH levels (P < .05). In this group, an increase in both urinary excretion of hydroxyproline and plasma osteocalcin levels paralleled a significant decrease in vertebral bone density (P < .0001). In OC-treated women, the pattern of osteocalcin showed no modification, whereas urinary excretion of hydroxyproline showed a decrease, which paralleled a significant (P < .001) increase in vertebral bone density.


CONCLUSIONS
Perimenopausal OC administration can prevent the increase in bone turnover and the decrease in bone density that follow the perimenopausal impairment of ovarian function.
Gambacciani
M
M
Department of Obstetrics and Gynecology, University of Pisa, Italy.
Spinetti
A
A
Taponeco
F
F
Cappagli
B
B
Piaggesi
L
L
Fioretti
P
P
D000328:Adult; D000704:Analysis of Variance; D015519:Bone Density / Q000187:drug effects*; D003276:Contraceptives, Oral / Q000008:administration & dosage / Q000627:therapeutic use*; D017135:Desogestrel / Q000008:administration & dosage / Q000627:therapeutic use*; D004997:Ethinyl Estradiol / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy* / Q000378:metabolism; D012044:Regression Analysis; D013131:Spine / Q000378:metabolism*
D003276:Contraceptives, Oral; D004997:Ethinyl Estradiol; D017135:Desogestrel