Percutaneous estrogen in prevention of early postmenopausal bone loss in Chinese women.

Objective To identify the optimal dosage of 17β estradiol gel+oral progestin for preventing bone loss in postmenopausal Chinese women Methods A 3 year open label, randomized, prospective clinical trial was conducted Sixty healthy women who had been postmenopausal for 1 to 5 years were recruited and divided into following 4 groups: group 1, percutaneous gel 17β estradiol (E 2) 1 5 mg/d plus micronized progesterone (MP) 100 mg/d; group 2, percutaneous gel 17β estradiol (E 2) 1 5 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d; group 3, percutaneous gel 17β estradiol (E 2) 0 75 mg/d plus micronized progesterone (MP) 100 mg/d; and group 4, percutaneous gel 17β estradiol (E 2) 0 75 mg/d plus medroxyprogesterone acetate (MPA) 2 mg/d Estrogen and progestin were given continuously for 25 days per month Bone mineral density (BMD) was measured using quantitative computed tomography (QCT) for trabecular bone of L2 5 and dual energy X ray absorptiometry (DEXA) for L2 4 and hip 5 times during the trial at baseline and at the 6 , 12 , 18 , 24 and 36 month visits Results Fifty nine patients (98 3%, 59/60) stayed in the study for 1 year, 56 patients (93 3%, 56/60) for 2 years, and 51 (85%, 51/50) for 3 years On average, menopausal symptoms were relieved by 80% after 6 months of treatment By the 24th month, the mean increase in BMD ranged from 4 3% to 7 5% in trabecular bone; and by the 36th month, it ranged from 4 2% to 6 2% in L2 4 and 1 61% to 3 77% in the neck There were significant difference after treatment ( P 0 05) Among the four groups, no significant difference ( P 0 05) was found in improvement of symptoms, levels of bone markers or BMD Conclusion A daily dose of estradiol gel, either 0 75 mg or 1 5 mg, is effective in preventing early postmenopausal bone loss and relieving menopausal symptoms After 3 year treatment, spinal BMD could increase steadily, so does hip BMD, especially in the first 2 years