The prevention of postmenopausal osteoporosis : effects of oral and transdermal hormone replacement therapy

Hillard, Timothy Charles (1994) The prevention of postmenopausal osteoporosis : effects of oral and transdermal hormone replacement therapy. University of Southampton, Doctoral Thesis.

Abstract

In a three year prospective controlled study 66 postmenopausal women were randomally allocated to receive either oral HRT (conjugated equine oestrogens 0.625mg/day continuously with 0.15mg/day dl-norgestrel added for the last 12 days of each 28 day cycle) or transdermal therapy (patches delivering 0.05mg/day oestradiol for the first 14 days of each 28 day cycle and 0.05mg oestradiol and 0.25mg norethisterone acetate daily for the second 14 days). 30 matched untreated women were studied concurrently as a control group.

At 3 years bone density had declined by 4% in the lumbar spine and more than 5% in the femoral neck in the untreated group. By comparison bone density increased with both treatments at both sites (p<0.001 vs untreated) and biochemical marker of bone turnover indicated a significant reduction in bone turnover. There were no significant differences between the treatment groups. 6 women (12%) on oral or transdermal treatments lost bone significantly at the femoral neck despite taking a dosage that was bone conserving for the group as a whole.

The relationship between excercise, as assessed by a 7-day physical activity recall questionnaire, and bone density at the lumbar spine and proximal femur was also explored. Higher levels of physical activity seem to be associated with greater bone density at various skeletal sites but exercise alone is probably insufficient to prevent postmenopausal bone loss.

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