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Hypergonadotropic hypogonadic amenorrhea (World Health Organization III) and osteoporosis
M Metka1, G Holzer, G Heytmanek
1First Department of Gynecology and Obstetrics, University of Vienna Medical School, Austria.
Objective:
To assess the bone mineral density in World Health Organization (WHO) III women after hormone replacement therapy.
Design:
We studied the bone mineral density of 41 women with premature ovarian failure (hypergonadotropic hypogonadic amenorrhea--WHO III) before and during hormone replacement therapy.
Setting:
All WHO III women were recruited from the Outpatient Department of the First Department of Gynecology and Obstetrics, University of Vienna Medical School, Austria, a public University Hospital.
Patients, Participants:
Forty-one patients, 30 healthy women.
Interventions:
Twenty-eight of 41 WHO III women received cyclic hormone replacement therapy consisting of 0.625 mg conjugated estrogen (days 1 to 30) and 5 mg medrogeston (days 20 to 30) in addition, with a 7-day interval.
Main Outcome Measure:
The bone mineral density was evaluated by single photon absorptiometry and dual energy x ray absorptiometry every 6 months (single photon absorptiometry six times, dual energy x ray absorptiometry four times).
Results:
The bone mineral density in young women with hypergonadotropic hypogonadic amenorrhea (WHO III) was lower than in age-matched controls. Hormone replacement therapy produced an increase in bone mineral density in 28 WHO III women, whereas bone mineral density remained quite constant in the women without therapy.
Conclusion:
Hormone replacement therapy increases the bone mineral density of women with hypergonadotropic hypogonadic amenorrhea. Hormones should be substituted early and consistently in affected patients.