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Bone metabolism changes after transdermal estradiol dose reduction during estrogen replacement therapy: a 1-year
E Cicinelli1, P Galantino, V Pepe
1Cattedra di Patologia Ostetrica e Ginecologica, University of Bari, Italy.
Maturitas
|August 1, 1994
Summary
Transdermal estrogen replacement therapy (ERT) in surgically menopausal women showed initial bone mineral density (BMD) gains. However, sustained therapy led to BMD decreases, particularly with lower estradiol doses.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Surgical menopause leads to rapid bone loss.
- Estrogen replacement therapy (ERT) is used to mitigate bone loss.
- Optimal transdermal estradiol dosage and duration for bone health remain under investigation.
Purpose of the Study:
- To evaluate the long-term effects of two different transdermal estradiol dosages on bone mineral density (BMD) and bone turnover markers in surgically menopausal women.
Main Methods:
- Twenty-four women received transdermal estradiol (E2) TTS at two different dose regimens (Group A: 0.05/0.025 mg/day; Group B: 0.10/0.05 mg/day) for 12 months.
- Bone mineral density (BMD) was measured using single photon absorptiometry.
- Serum E2, alkaline phosphatase (AP), osteocalcin (BGP), and urinary hydroxyproline (OHP) were assessed at baseline and follow-up points.
Main Results:
- Both groups showed initial increases in cortical and trabecular BMD after 6 months.
- Group A experienced significant decreases in BMD after 12 months, while Group B maintained BMD.
- Bone turnover markers (AP, OHP, BGP) initially increased post-surgery and then showed varied responses to ERT.
Conclusions:
- Transdermal ERT can initially improve BMD in surgically menopausal women.
- Lower-dose transdermal estradiol may not sustain bone protective effects long-term.
- Further research is needed to determine optimal ERT regimens for long-term bone health.