Bone loss in elderly women prevented by ultralow doses of parenteral 17beta-estradiol.
OBJECTIVE
Our purpose was to assess whether an ultralow dose of parental estradiol, aimed for treatment of vaginal atrophy, affects bone metabolism and bone density.


METHODS
Thirty healthy women > or = 60 years old were randomly assigned to a 6-month treatment with either an ultralow dose of parenteral estradiol (7.5 microg/24 hours) delivered by vaginal rings or no treatment in the proportion 2:1.


RESULTS
Forearm bone density increased in estradiol users by 2.1% (95% confidence interval 0.4 to 3.8, p = 0.008), contrasting to a decrease in nonusers of -2.7% (95% confidence interval -5.9 to 0.4, p = 0.077). In analysis of variance the changes in the two study groups differed significantly (p = 0.0004). Consistently, serum alkaline phosphatases, bone-specific alkaline phosphatases, and osteocalcin concentrations decreased in the treatment group (8%, p = 0.019; 14%, p = 0.0006; and 9%, p = 0.02, respectively), suggesting reduced bone turnover. No significant changes were found in nonusers.


CONCLUSIONS
Ultralow doses of estradiol may potentially prevent bone loss in women > or = 60 years old.
Naessen
T
T
Department of Obstetrics and Gynecology, University Hospital, Uppsala, Sweden.
Berglund
L
L
Ulmsten
U
U
D000282:Administration, Intravaginal; D000368:Aged; D000375:Aging / Q000502:physiology*; D000469:Alkaline Phosphatase / Q000097:blood; D000704:Analysis of Variance; D001284:Atrophy; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D001842:Bone and Bones / Q000378:metabolism; D002118:Calcium / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004970:Estrone / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D014623:Vaginal Diseases / Q000188:drug therapy / Q000473:pathology
D015675:Osteocalcin; D004970:Estrone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D000469:Alkaline Phosphatase; D002118:Calcium