The effect of various hormonal preparations and calcium supplementation on bone mass in early menopause. Is there a predictive value for the initial bone density and body weight

Abstract. Pines A, Katchman H, Villa Y, Mijatovic V, Dotan I, Levo Y,. Ayalon D (Ichilov Hospital, Tel-Aviv; Ramat Marpe Hospital, Ramat-Gan, Tel-Aviv, Israel. VU Ziekenhuis, Amsterdam, The Netherlands). The effect of various hormonal preparations and calcium supplementation on bone mass in early menopause. Is there a predictive value for the initial bone density and body weight? J Intern Med 1999; 246: 357–361. Objectives. To compare the effect of various oestrogen and oestrogen/progestin preparations on bone density over a 2-year follow-up period in early postmenopausal women. Setting. A retrospective study on 315 women followed in a menopause clinic. Design. Antero-posterior lumbar spine bone densitometry was performed at baseline and between 18 and 24 months (mean 22 months) after initiation of hormone therapy. Participants were divided into six groups: women taking conjugated equine oestrogen (CEE) (n = 30); CEE plus sequential monthly medroxyprogesterone acetate (MPA) (n = 52); CEE plus sequential bimonthly MPA (n = 51); oral estradiol plus sequential monthly norethisterone acetate (n = 52); transdermal estradiol plus sequential monthly MPA (n = 30). A control group (n = 100) was composed of nonusers of hormones. Results. Hormone users, as a whole (n = 215), increased their bone mineral density (BMD) by 2.9% (4.8) as compared to the controls who lost 3.5% (3.4; P  100%) actually lost bone despite hormone treatment [–2.1% (4.1)]. Conclusions. All hormone regimens had a similar bone conserving effect. Basal BMD value may serve as a predictor for the success of treatment. Calcium supplementation should be recommended in all postmenopausal women.