Impacts of Added Progestogen on the Bone Mineral Densities and Bone Metabolism of Postmenopausal women undergoing Estrogen Replacement Therapy

Kim, H Y; Park, E D

Abstract

In postmenopausal women with uterus, progestogen should be added to protect the endometrium from the hyperplasia or carcinoma induced by unopposed estrogen. However the effect of progestogen on bone mineral density & bone metabolism had not been precisely evaluated in Korean post menopausal women. To evaluate the impacts of progestogen on bone mineral density & bone metabolism during estrogen replacement therapy, we conducted the randomized 2-year trials of 3 group: Group I was 145 women recieved estrogen only (premarine 0.625mg/day), Group II was 55 women received estrogen with cyclic addition of progestogen (medroxyprogesteron, MPA, 5mg/day for 2 days for month), Group III was 55 women received estrogen with daily addition of progestogen (MPA 2.5mg daily). In all subjects, bone mineral density was measured in the lumber vertebrae (L2-L4) and femur neck using dual energy X-ray absorptiometry (DEXA) and serum osteocalcin and urine calcium/creatinine was measured at the beginning of the treatment 12 months and 24 months later, repectively. BMD of femur neck in Group I, Group II and Group III increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly during the treatment in Group I, Group II and Group III. Serum osteocalcin in Group I, Group II and Group III decreased significanly at 12 months and 24 months of treatment compared with initial value. Urinary calcium/creatinine ratio in Group I, Group II and Group III decreased significantly at 12 months and 24 months of treatment compared with initial value. And compared with Group I, Group II and Group III did not significant difference. From the above results, it might be suggested that added progestogen during Estrogen Replacement Therapy is more effective in post menopausal women with the protection on bone mineral density.