Difference in bone acquisition among hormonally treated postmenopausal women with normal and low bone mass.

This prospective analysis was conducted to compare the effects of hormone treatments on bone mineral density (BMD) of the lumbar spine, hip, and distal forearm in postmenopausal women with normal BMD and those with low bone mass. Eighty healthy women were randomly assigned to receive a cyclic regimen of standard hormone replacement therapy (HRT) or currently used low-dose oral contraceptive (OC). Women were categorized as normal BMD and low bone mass according to the Thai reference database. The results revealed that women with low bone mass gained more BMD than those with normal BMD. The difference in mean per cent bone acquisition was obvious at the spine. In addition, further subset analysis into OC and HRT groups revealed higher effects of OC on BMD when compared to HRT.

Clinical study of a monophasic pill containing 20 microg ethinylestradiol and 150 microg desogestrel in Thai women.

OBJECTIVES: To evaluate the contraceptive reliability and clinical effects of a monophasic oral contraceptive containing 20 microg ethinylestradiol and 150 microg desogestrel (Mercilon) in Thai women. METHOD: The study was carried out at the Family Planning Clinic of King Chulalongkorn Memorial Hospital, Bangkok, Thailand. One hundred and forty six healthy women of fertile age were enrolled and treated with the study oral contraceptives for 12 cycles. Clinical data of vaginal bleeding, side effects, blood pressure and body weight were assessed periodically. RESULTS: One thousand four hundred and twenty five cycles were evaluated. No conception occurred. The cycles were almost regular. The incidence of irregular bleeding was highest in the first cycle, after the third cycle, the value was below 4 per cent. Side effects were very few. There was no change in blood pressure. A slight decrease in mean body weight was observed. CONCLUSION: The oral contraceptive containing 20 microg ethinylestradiol and 150 microg desogestrel has high contraceptive efficacy, good cycle control and minimal side effects.

Bone mineral density of lumbar spine and proximal femur in normal Thai women.

OBJECTIVE: To find the reference data for age-specific normal bone mineral density in a Thai female population. STUDY DESIGN: Cross-sectional, Descriptive study. MATERIAL AND METHOD: 1773 Thai women aged between 11-80 years were recruited, using multistage cluster sampling and stratifying from six represented provinces in the country, each strata was randomly selected. After recruiting, the women were interviewed by well-trained personnel using structured questionnaires. Bone mineral density of the lumbar spine 1-4 and nondominant hip were measured by Dual Energy Photon Absorptiometer. The scientists, X-rays technician were trained and standardized inter and intra observers variation. Quality control of examination was measured periodically. Every BMD outcome was re-examined by a specialist. RESULTS: The peak bone mineral density of both spines and hips was between the age of 30 to 34 years old. Mean Value for spine and femoral neck was 0.957 and 0.814 g/cm2 respectively. The BMD of spine and hip was significantly decreased after the age of 35 and the loss was accelerated at age 50. Osteoporosis for spine and femoral neck is considered when BMD are below 0.682 and 0.569 g/cm2 respectively. CONCLUSION: The results are important data for public health policy, by maximizing bone mass during skeletal growth before menopause and minimizing bone loss throughout life as well as for detection of important risk factors.

Bone loss in oophorectomized Thai women.

This prospective analysis was done in 95 postmenopausal women to observe bone loss rate between 59 natural and 36 surgical menopausal women with or without hormonal replacement therapy (HRT). Bone mass measurement was performed at lumbar spines (L1-L4) and hip by dual energy X-ray absorptiometer at 0, 6 and 12 months. The results revealed that in the non-HRT group there was significant faster bone loss rate of lumbar spines (LS) and hip (H) of the surgical group at 12 months (Natural group: LS = -1.11%, H = +2.38%; Surgical group: LS = -4.51%, H = -0.66%, P < 0.05). However, there was no significant difference in bone changes of lumbar spines and hip between natural and surgical group with HRT at 12 months (Natural: LS = +2.0%, H = +4.06%; Surgical: LS = +0.62%, H = +2.28%, P > 0.05). This observation showed that without HRT oophorectomized women had greater magnitude of bone loss than women who entered menopause naturally.

Hormonal replacement and lipid changes in postmenopausal women.

To assess the effect of hormonal replacement therapy on lipid changes, measurement of serum total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), apolipoprotein A-1 (Apo-A) and apolipoprotein B (Apo-B) was performed on 93 postmenopausal women. Women in the study group (HRT) (51/93) received estrogen with or without progestin. The control group (Non-HRT) (42/93) did not receive any hormone regimen. The measurement was done at 0, 6 and 12 months. The results revealed that triglyceride increased significantly more in the non-HRT than the HRT group at 6 and 12 months. (Non-HRT: +21.7%, +21.7%; HRT: -2.8%, +2.4%, respectively P < 0.05). However, there was no significant difference in changes of other lipid profiles between the two groups at 6 and 12 months (Non-HRT: TC -2.7%, +0.7%, HDL +2.9%, +5.1%, LDL -5.2%, -4.1%, Apo-A +0.5%, +0.9%, Apo-B +3.8%, +1.3%: HRT: TC -1.4%, -2.8%, HDL +4.7%, +6.2%, LDL -1.5%, -4.9%, Apo-A -0.9%, +1.6%, Apo-B -2.6%, -1.6%, respectively P > 0.05). The paradoxical changes of triglyceride and HDL might partly be explained by the effect of progestins used in this study.

Bone changes in postmenopausal Thai women with or without hormonal replacement therapy.

Bone mass measurement was performed in 95 healthy postmenopausal women to assess the effect of hormonal replacement therapy (HRT) on bone changes. Women in the study group (51/95) received estrogen with or without progestin. The control group (44/95) did not receive any hormone regimen. The measurement was done at lumbar spines (L1-L4) and hip by dual energy X-ray absorptiometer at 0, 6 and 12 months. The results revealed significantly higher per cent changes of bone density of lumbar spines and hip, at 12 months, in the study group than in the control. (Study: Lumbar Spine +1.76%, Hip +3.57%; Control: Lumbar spines -2.32%, Hip +1.32%, P < 0.05). In conclusion, this study showed the value of hormonal replacement therapy for prevention of postmenopausal bone loss in Thai women.