The Combination Therapy of Low Dose Estrogen and Fluoride (Monofluorophosphate) for 2 Years in Postmenopausal Women with Osteopenia

OBJECTIVE: To investigate the changes of BMD (bone mineral density), biochemical bone markers and lipid profiles after combination therapy of low dose estrogen (0.3 mg) and intermittent fluoride (monofluorophosphate) in postmenopausal osteopenia. METHOD: We studied 61 women with postmenopausal osteopenia from March 2002 to May 2005. Group I (n=30) was treated with low dose estrogen (0.3 mg), fluocalcic(R) (monofluorophosphate 100 mg+calcium 500 mg), and calcium (500 mg). Group II (n=31) was treated with standard dose estrogen (0.625 mg) and calcium (1,000 mg). BMD at the lumbar spine and femur, osteocalcin, deoxypyridinoline, and lipid profiles were measured at baseline and 2-year after treatment. RESULTS: 1) Average postmenopausal periods were 2.8 years and 3.1 years in Group I and II, respectively. 2) BMD increased significantly in two groups, and BMD in group I increased significantly more than that in group II. 3) Deoxypyridinoline decreased significantly in two groups, and there was no significant difference between the two groups. 4) Total cholesterol and LDL cholesterol decreased significantly in two groups. CONCLUSION: Combination therapy with monofluorophosphate and low dose estrogen in postmenopausal osteopenia was more effective than standard dose estrogen therapy to prevent postmenopausal osteoporosis.

Therapeutic Effect according to Estrogen Dosage on Combined Therapy with Estrogen and Alendronate in Postmenopausal Osteoporosis

OBJECTIVE: To compare the difference of bone mineral density (BMD), biochemical markers, and lipid profiles according to dosage of estrogen on combined therapy with estrogen and alendronate in postmenopausal osteoporosis. METHOD: We studied 81 women with postmenopausal osteoporosis (T-score<2.5) from March 2002 to February 2005. Subjects were divided in two groups; Group I (n=36), treated with low dose hormone therapy (HT) (0.3 mg estrogen/1.25 mg MPA (Medroxyprogesterone acetate)) and alendronate, and Group II (n=45), treated with standard dose HT (0.625 mg estrogen/2.5 mg MPA) and alendronate. BMD at the L-spine and femur, osteocalcin, deoxypyridinoline, and lipid profiles were measured at baseline and 1 year after treatment. RESULTS: BMD at the L-spine increased significantly in two groups and BMD at the femur increased but showed no statistical differences. Deoxypyridinoline and osteocalcin decreased significantly in two group. Total cholesterol and LDL (low density lipoprotein) cholesterol decreased significantly in two groups, no significant difference was observed between two groups in BMD, osteocalcin, deoxypyridinoline, and lipid profiles. CONCLUSION: We concluded that combined therapy with low dose estrogen and alendronate in postmenopausal osteoporosis showed similar therapeutic effect provied by combined therapy of standard dose estrogen and alendronate.

The short-term effects of low-dose estrogen and micronized progesterone on bone turnover markers and serum lipid profiles in postmenopausal women / 대한내과학회지

BACKGROUND: Hormone replacement therapy in postmenopausal women is widely used for the relief of menopausal symptoms and the prevention of bone loss. But, it has been reported that many women discontinue hormone replacement therapy within early period, because the women suffer from breast pain, bleeding and weight gain. Also, further adverse influence of hormone replacement therapy on cardiovascular risk and breast cancer has been suggested. There are many controversies due to conflicting data of that. Recent studies suggest that low-dose estrogen provide bone benefits and micronized progesterone have favorable effects on lipid metabolism and breast density. This clinical trial evaluated the short-term effects of low-dose estrogen and micronized progesterone on bone turnover markers and serum lipid profiles in postmenopausal women. METHODS: This was a 12-week study in which 90 postmenopausal women received hormone replacement therapy. Participants were assigned in equal numbers to the following groups: (1) daily treatment with 0.625 mg conjugated equine estrogens (CEE) with medroxyprogesterone acetate MPA 2.5 mg to 5 mg, daily or cyclically; (2) daily treatment with 0.625 mg CEE with micronized progesterone (MP) 100 mg to 200 mg, daily or cyclically; (3) daily treatment with 0.3 mg CEE with MP 100 mg to 200 mg, daily or cyclically. Changes in bone turnover markers and serum lipid profiles were assessed. RESULTS: At 12-week, all treatment groups significantly improved bone turnover markers and serum lipid profiles, specifically serum alkaline phosphatase, serum osteocalcin, urine deoxypyridinoline and serum high density lipoprotein cholesterol level. CEE 0.625/MPA and CEE 0.625/MP significantly decreased serum low density lipoprotein cholesterol level. CEE 0.625/MPA significantly increased serum triglyceride level. CEE 0.625/MPA produced greater decreases in serum alkaline phosphatase level than CEE 0.625/MP and CEE 0.3/MP. CEE 0.625/MP produced greater increases in serum high density lipoprotein cholesterol level than CEE 0.625/MPA. CEE 0.625/MPA produced greater increase in serum triglyceride level than CEE 0.3/MP. CONCLUSION: Low-dose estrogen and MP generally improved bone turnover markers and serum lipid profiles. But, MP produced lesser favorable effects on a part of bone turnover markers. MP produced significantly greater increases in serum high density lipoprotein cholesterol than that of MPA. And Low-dose estrogen produced significantly lesser increases in triglyceride than that of conventional dose.