Description of bone mineral density in postmenopausal women at Immunoendocrinology Integrated Laboratory, Faculty of Medicine University of Indonesia.

To identify the pattern of bone mineral density in postmenopausal women through retrospective study in 40 postmenopausal women using Dexa instrument in bones (L2 - L4). Results with 15% of survey formula accuracy were found: mean of menopausal age was 53.25 years, normal bone mineral density 30%, osteopenia 52.5%, and osteoporosis 17.5%. A very strong relationship (r=0.547) and a significant relationship (p=0.000) between body height and bone mineral density were found in this study, and there was a moderate (r=0.315) and significant (p= 0.047) relationship between body weight and bone mineral density, and likewise there was a moderate (r=-0.301) and significant (p=0.059) relationship between duration of menopause and bone mineral density. By contrast, no relationship was found between age (r=0.119) and Body Mass Index (BMI) (r=0.086) and bone mineral density.

Effects of continuous Hormone Replacement Therapy (HRT) on FSH, lipid profiles, blood chemistry, and skin thickness in menopausal women.

This study was aimed to observe the effect of hormone replacement therapy (HRT) of estradiol 2 mg + 1 mg acetate noretisterone administered continuously on FSH hormone, lipid profile, blood chemistry, and skin thickness in menopausal women. The duration of HRT administration was 6 months. The subjects of the study were 35 menopausal women. The study was conducted from January 2001 to June 2001. After HRT administration of 6 months, a significant decrease of FSH was observed. No effect of HRT was found in bilirubin level; however, there was a slight increase of alkali phosphatase enzyme, and a signifcant increase in SGOT and SGPT. HRT caused a decrease of total cholesterol level and triglyceride level. In addition, a slight increase of LDL level and significant decrease of HDL level were observed. HRT administration with progesterone synthetic noretisterone showed an increase of skin collagen synthesis, which was indicated by the significant increase of skin thickness.

Selective estrogen receptor modulators (SERM): A new choice for postmenopausal women and physicians who worry on cancer.

The postmenopausal state is characterized by the cessation of menstruation, loss of ovarian function, and a dramatic decrease in the level of circulating estrogen. This state of estrogen deficiency contributes to the acceleration of several age-related health problems in women, including cardiovascular disease, osteoporosis, and dementia. Estrogen replacement is clearly effective in the short-term and long-term treatment and prevention of postmenopausal symptoms. However, until now, the amount of HRT user is still very low. Fear of breast cancer and endometrial cancer are the most common concern in using hormone replacement therapy (HRT), although the relationship between long-term HRT and breast cancer remains controversial. For physicians or patients, who worry on cancer, the ideal drug is now available i.e. the selective estrogen receptor modulators (SERM), with the generic name raloxifine.

Controversies in hormone replacement therapy.

Deficiency of estrogen hormone will result in either long-term or short-term health problems which may reduce the quality of life. There are numerous methods by which the quality of female life can be achieved. Since the problems occuring are due to the deficiency of estrogen hormone, the appropriate method to tackle the problem is by administration of estrogen hormone. The administration of hormone replacement therapy (HRT) with estrogen may eliminate climacteric complaints, prevent osteoporosis, coronary heart disease, dementia, and colon cancer. Although HRT has a great deal of advantage, its use is still low and may result in controversies. These controversies are due to fact that both doctor and patient still hold on to the old, outmoded views which are not supported by numerous studies. Currently, the use of HRT is not only based on experience, or temporary observation, but more on evidence based medicine.