Maturitas
Volume 57, Issue 4 , Pages 370-381, 20 August 2007

The effect of transvaginal estradiol on bone in aged women: A randomised controlled trial

  • Helena S. Salminen

      Affiliations

    • Centre for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden
    • Corresponding Author InformationCorresponding author at: Centre for Family and Community Medicine, Alfred Nobels Allé 12, S-14183 Huddinge, Sweden. Tel.: +46 8 52488735; fax: +46 8 52488706.
    • ,
  • Maria E. Sääf

      Affiliations

    • Department of Endocrinology, Metabolism and Diabetes, Karolinska Hospital and Karolinska Institutet, Stockholm, Sweden
    • ,
  • Sven-Erik Johansson

      Affiliations

    • Centre for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden
    • ,
  • Hans Ringertz

      Affiliations

    • Department of Surgical Sciences, Section for Diagnostic Radiology, Karolinska Institutet, Stockholm, Sweden
    • ,
  • Lars-Erik Strender

      Affiliations

    • Centre for Family and Community Medicine, Karolinska Institutet, Stockholm, Sweden

Received 3 January 2007; received in revised form 19 March 2007; accepted 21 March 2007. published online 25 April 2007.

Abstract 

Objectives

To investigate the effect of transvaginal estradiol on bone mineral density and bone metabolism.

Methods

One hundred and fifteen women (mean age 73.8±3.2 years) were randomly assigned to a 2-year open-label parallel group clinical trial and were treated with either transvaginal estradiol (7.5μg/24h), or no estradiol. Both groups received 400 IU vitamin D and 500mg calcium/day. The bone mineral density (BMD) was assessed in the hip and spine using DXA technique and in the heel using DXL technique.

Results

The intention to treat analysis showed that the increase in BMD in the estradiol group was significant at total hip by 0.6% (P=0.04) while the control group decreased in their BMD by 0.7%. At lumbar spine the estradiol group increased in BMD by 2.6% (P=0.011) while the control group increased by 2.2%. Bone turnover markers and PTH-levels decreased while 25-OH vitamin D levels increased in both groups, a probable effect of the calcium and vitamin D supplementation. The bone resorption marker CTx decreased more significantly in the treatment group (P=0.016).

Conclusions

The transvaginal estradiol treatment of 7.5μg/24h had a small but significant effect on the BMD of total hip and lumbar spine after a follow-up of 2 years.

Keywords: Osteoporosis, Elderly women, Low dose transvaginal estradiol, Randomised controlled trial

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PII: S0378-5122(07)00125-9

doi:10.1016/j.maturitas.2007.03.005

Maturitas
Volume 57, Issue 4 , Pages 370-381, 20 August 2007

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