Postmenopausal femur bone loss: effects of a low dose hormone replacement therapy

Objectives: Previous studies indicate that low-dose hormone replacement therapy (LD-HRT) can relieve vasomotor symptoms and prevent spine bone loss. Methods: In the present study, we evaluated the effects of a low dose of conjugated equine estrogens (CEE; 0.3 mg) associated with different progestins in continuous combined scheme [2.5 mg of medroxyprogesterone acetate (n = 25), 5 mg dydrogesterone (n = 27), 2.5 mg nomegestrol (n = 11)] as single group, on femur bone mineral density (BMD) and bone metabolism in young postmenopausal women (less than or equal to56 years). All women were supplemented with 1 g of calcium per day, and compared with women treated with I g of calcium per day alone (control group, n = 15). There were no significant differences in age, body mass index (BMI), hormone values, bone metabolism markers and femur BNID in the treatment and control groups before the study. Results: In calcium-treated women serum plasma osteocalcin (BGP) and hydroxyproline/creatinine urinary excretion (OHP/Cr) remained stable during all the observation period. In this group, femoral neck, Ward's triangle and trochanter BMD showed a progressive and significant (P < 0.05) decrease. In the LD-HRT group, a significant (P < 0.05) decrease in serum BGP and OHP/Cr was observed. In these women, the values of these markers of bone turnover at 36 months were significantly (P < 0.01) different from those of calcium-treated women. During the LD-HRT administration, all BMD measures did not show any significant modifications. In these women, treated with LD-HRT the BMD values were significantly (P < 0.05) different from those measured in calcium-treated women in a I the femur sites of measurements. In the control: group, BMI significantly (P < 0.05) increased from baseline value with a weight gain of 3%, while in the LD-HRT group, BMI did not change after 36 months of treatment and the 1.3% gain in body weight was not significant. LD-HRT. was effective in reducing menopausal clinical symptoms and,provided a favorable bleeding profile, and minimal side effects. Conclusion: LD-HRT was effective in reducing menopausal clinical symptoms, and minimal and transient side effects were reported. In addition, the 0.30 mg/day of CEE, in addition to a proper calcium supplementation, irrespective of the progestin used, can provide effective protection,against activation of bone turnover and femur osteopenia. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.