Hormone Therapy Reduces Bone Resorption but not Bone Formation in Postmenopausal Athletes.

INTRODUCTION: Independently, hormone therapy and exercise have well-established protective effects on bone parameters. The combined effects of hormone therapy and exercise, however, are less clear. We, therefore, examined the effects of hormone therapy on bone turnover markers in postmenopausal women undergoing regular high intensity exercise. METHODS: In a randomised, double blind study, postmenopausal athletes competing at Masters level, received either hormone therapy (50 µg transdermal oestradiol, 5 mg MPA, n = 8) or placebo (n = 7) for 20 weeks. Women were tested before and after treatment for plasma concentrations of oestradiol, FSH, LH, and serum bone formation marker -osteocalcin (OC); and urine bone resorption markers-pyridinoline (PYD) and deoxypyridinoline (DPD). RESULTS: As a result of treatment with hormone therapy there were significant reductions in levels of FSH (73.3 ± 13.7 to 48.6 ± 10.5 mmol/L, p = 0.01) and bone resorption markers (PYD, 81.9 ± 7.7 to 57.8 ± 3.7 nmol/mmol Cr, p = 0.001, and DPD, 18.5 ± 3.1 to 11.8 ± 2.1 nmol/mmol Cr, p = 0.01). Oestradiol and bone formation markers were not significantly altered as a result of hormone therapy. There were no changes to any variables with placebo treatment. CONCLUSION: Hormone therapy reduced bone resorption, but not bone formation, in postmenopausal athletes. These favorable reductions in bone turnover; therefore, provide an effective treatment in combination with high intensity exercise to further reduce the subsequent risk of osteoporosis and associated fractures.

Effects of exercise on bone density and falls risk factors in post-menopausal women with osteopenia: a randomised controlled trial.

OBJECTIVES: This study aimed to determine the efficacy of an exercise program for post-menopausal women with osteopenia undertaken in community exercise facilities. DESIGN: Randomised, single-blind controlled trial. METHODS: Thirty-nine community volunteers with hip osteopenia and not taking bone-enhancing medication were randomly allocated to an exercise (EX) or control (CON) group. EX participants attended an exercise facility in Melbourne, Australia, three times/week for 52 weeks (with a 2 week break) for partially supervised exercises targeting hip bone strength, muscle strength and balance. They also performed daily jumping exercises at home. CON participants continued with their usual care. All participants were given calcium supplementation. Assessment at baseline and 52 weeks measured bone mineral density (BMD) at the proximal femur and lumbar spine. Health-related quality of life (QOL) and objective measures of strength and balance were also collected. RESULTS: ANCOVA adjusting for baseline values revealed a small benefit of exercise in mean total hip BMD (the primary outcome) with a significant mean difference in change between groups of -0.012 g/cm(2) (95% CI -0.022 to -0.002 g/cm(2)). EX participants improved 0.5% compared with a 0.9% loss for CON participants. The only other between-group differences were in QOL and a test of trunk and upper limb endurance, which both favoured the EX group. CONCLUSIONS: This exercise program appears to have modest benefits for post-menopausal women with osteopenia who are not taking bone-enhancing medication. This mode of exercise delivery has adherence and progression limitations but may be appropriate to recommend for some people.