Effect of low-dose or standard-dose conjugated equine estrogen combined with different progesterone on bone density in menopause syndrome women
10.3760/cma.j.issn.0529-567x.2018.04.007
- VernacularTitle:低剂量与标准剂量结合雌激素联合不同孕激素应用对围绝经期综合征患者骨密度的影响
- Author:
Hongling ZUO
1
,
2
;
Yan DENG
;
Yanfang WANG
;
Lihong GAO
;
Wei XUE
;
Shiyang ZHU
;
Xiao MA
;
Aijun SUN
Author Information
1. 100730 中国医学科学院北京协和医院妇产科
2. 050000 石家庄,河北医科大学第二医院妇产科
- Keywords:
Perimenopause;
Osteoporosis;
postmenopausal;
Hormone replacement therapy;
Bone density;
Estrogen replacement therapy;
Dose-respone relationship;
drug
- From:
Chinese Journal of Obstetrics and Gynecology
2018;53(4):243-247
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of low-dose or standard-dose conjugated equine estrogen (CEE)combined with natural progesterone or dydrogesterone on bone density in menopause syndrome women.Methods Totally 123 patients with menopause syndrome were recruited and randomly assigned to 3 treatment groups: group A(low-dose CEE+progesterone), group B(standard-dose CEE+progesterone), group C(standard-dose CEE+dydrogesterone). Using continuous sequential regimen, the duration of intervention was 12 cycles.The bone mineral density of lumbar 2-4 and neck of femur,the bone metabolic markers, the level of FSH and estradiol were examined just before the drug administration and 12 months after the beginning of experiment. Results There were 107 cases completed the one year trial.(1)Bone density:after 12 cycles of treatment,there was no significant change in bone density in group A(P>0.05);lumbar vertebrae of group B and C increased significantly,at 3.0% and 2.1%respectively(all P<0.05).The bone density of left femoral neck of group C significantly increased by 2.9%(P=0.029). There was no significant difference among the treatment groups at the beginning of experiment(P>0.05).(2)Bone metabolic markers: after 12 cycles of treatment, the levels of calcium, phosphorus, alkaline phosphatase, Ca/Cr decreased significantly,the difference were statistically significant(all P<0.05).There was no significant difference among the treatment groups at the beginning of experiment(P>0.05).(3)Levels of FSH and estradiol:after 12 cycles of treatment,the levels of FSH in three groups were decreased significantly(all P<0.01). The levels of estradiol in three groups were increased significantly(all P<0.01). There was no significant difference among the treatment groups at the beginning of experiment(P>0.05). Conclusions Both low-dose and standard-dose menopause hormone therapy(MHT)could elevate the level of estradiol, reduce bone turnover, prevent bone loss of postmenopausal women effectively. The standard dose of MHT could also increase the density of vertebrae and femoral neck,and generate more clinical benefits.
