ABSTRACT
The purpose of this study was to examine the influence of estrogen-progestin replacement therapy and exercise on the lumbar spine mobility and back symptoms of early postmenopausal women. The population sample consisted of 78 healthy, 49- to 55-year-old women, 0.5-5 years after menopause, who were randomized into three groups, two receiving different protocols of estradiol valerate combined with medroxyprogesterone acetate replacement therapy, and the third group a placebo. These groups were then randomized into exercise and control cases and monitored for 2 years. The mobility of the lumbar spine was measured and symptoms investigated using the Million and Oswestry pain and disability questionnaires and pain drawings at the baseline and after 1 and 2 years. During the follow-up, the mobility of the lumbar spine decreased in all six groups. The decrease was most evident in those who had been the most flexible at baseline (P < 0.0001). The decrease was less notable in the hormone replacement therapy groups than in the control group. When the replacement therapy groups were pooled together, the difference was significant at a P < 0.05 level. No difference was seen between the hormone combinations. The exercise intervention was insufficient to influence lumbar spine mobility. Only sporadic cases of back symptoms appeared and disappeared among the subjects during the follow-up, and no preventive or aggravating effects of hormone replacement therapy or the exercise program on symptoms were detected.
Subject(s)
Estrogens/therapeutic use , Exercise Therapy , Hormone Replacement Therapy , Low Back Pain/drug therapy , Progestins/therapeutic use , Spine/physiopathology , Disability Evaluation , Female , Humans , Lumbosacral Region , Middle Aged , Pain Measurement , Postmenopause/physiology , Reproducibility of ResultsABSTRACT
OBJECTIVES: To evaluate the effect of 1- or 3-monthly sequential combinations of estradiol valerate (E2V) and medroxyprogesterone acetate (MPA) on menopausal symptoms, bone density, muscle strength and lipid metabolism in postmenopausal women. METHODS: Changes in bone mineral density (BMD), isometric muscle strength, serum lipids and climacteric symptoms were evaluated in 78 women, 49-55 years of age, with a spontaneous menopause 0.5-3 years earlier. Treatment group I received 2 mg E2V tablets for 11 days, followed by 2 mg E2V + 10 mg MPA for 10 days and placebo for an additional 7 days; treatment group II received 2 mg E2V for 70 days, 2 mg E2V + 20 mg MPA for 14 days, and placebo for 7 days. The placebo group received placebo continuously for 24 months. Each group was further randomised to exercise and non-exercise subgroups. RESULTS: Both hormone regimens significantly reduced menopausal symptoms, and prevented equally well the decrease of BMD both in the lumbar spine and proximal femur. A positive effect of exercise on BMD was observed in the placebo group. No synergistic effect of exercise and estrogen on BMD could be shown. Both hormone regimens increased the isometric strength of back extensor muscles. Serum total and LDL cholesterol decreased during the first year with both estrogen regimens. CONCLUSIONS: Estrogen-progestin regimens were equally effective in the control of menopausal symptoms and preventing bone loss, increasing muscle strength and lowering serum cholesterol.
Subject(s)
Bone Density , Estradiol/analogs & derivatives , Estrogen Replacement Therapy , Estrogens, Conjugated (USP)/therapeutic use , Exercise Therapy , Lipid Metabolism , Medroxyprogesterone Acetate/therapeutic use , Muscle Contraction , Muscle, Skeletal/physiology , Postmenopause , Progesterone Congeners/therapeutic use , Cholesterol/blood , Cholesterol, LDL/blood , Climacteric/drug effects , Estradiol/administration & dosage , Estradiol/therapeutic use , Estrogens, Conjugated (USP)/administration & dosage , Female , Femur/drug effects , Humans , Isometric Contraction/drug effects , Lipids/blood , Lumbar Vertebrae/drug effects , Medroxyprogesterone Acetate/administration & dosage , Menopause/drug effects , Middle Aged , Muscle Contraction/drug effects , Muscle, Skeletal/drug effects , Osteoporosis, Postmenopausal/prevention & control , Placebos , Postmenopause/drug effects , Progesterone Congeners/administration & dosage , Prospective StudiesABSTRACT
In this cross-sectional population study with 78 healthy 0.5-5 years postmenopausal, 49-55 year old females a significant simple linear correlation between lumbar spine LII-LIV bone mineral density and adjacent back extensor and flexor isometric muscle strength was found. With the stepwise multiple linear regression analyses the most significant predictors for lumbar spine LII-LIV and femoral neck bone mineral density were weight (partial R2) (R2 = 0.197, p = 0.0001; R2 = 0.157, p = 0.0009) and age (R2 = 0.056, p = 0.0205; R2 = 0.036, p = 0.0708). Height and isometric muscle strength and endurance of muscles were not significant predictors. Weight and age were the most significant predictors also for isometric muscle strength. The mobility of spine, body fat content and anaerobic threshold had no correlation on bone mineral density.
Subject(s)
Back , Bone Density , Femur Neck/chemistry , Lumbar Vertebrae/chemistry , Menopause , Muscle Tonus , Absorptiometry, Photon , Age Factors , Body Weight , Cross-Sectional Studies , Female , Femur Neck/diagnostic imaging , Finland , Humans , Lumbar Vertebrae/diagnostic imaging , Middle Aged , Predictive Value of TestsABSTRACT
We studied the effects of physical activity and two types of estrogen treatment in a prospective study in 78 healthy postmenopausal women. A control group and two treatment groups receiving estradiol valerate and medroxyprogesterone acetate in 1- or 3-month cycles were monitored for 1 year. Half of each group took part in an exercise program. Lumbar and femoral bone mineral density increased in both of the estrogen-treatment groups. Physical exercise with estrogen treatment did not result in further increases in bone mineral densities.
