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Abstract
Objectives: To evaluate the effectiveness of transdermal oestrogen replacement therapy plus medrogestone
(HRT) in postmenopausal bone loss prevention by means of US. Methods: We enrolled 112 healthy postmenopausal women in an open, prospective study. These
women, after a gynaecological evaluation and an US assessment of the skeletal status,
were advised to take cyclic sequential oestrogen/progestagen therapy: 50 μg/day of
transdermal 17β-oestradiol (Rotta Research Laboratorium) plus 5 mg/day of medrogestone,
for 12 days per cycle (Wyeth-Ayerst). After 1 year we recalled these women: only 32
of them were taking HRT, while 49 had declined HRT without taking alternative therapies.
The remaining women were excluded from the study as they were either unavailable for
the check-up or they were taking prohibited therapies. We used DBM Sonic 1200 (Igea,
Italy) to assess US parameter changes at phalanxes at enrolment and after 1 year.
This device enabled us to evaluate US transmission velocity (AD-SoS) and US attenuation
pattern (UBPS). In a previous study we had evaluated the intra- and inter-observer
reproducibility of AD-SoS measurements (0.4 and 1.0% respectively). Using the same
data we evaluated the intra- and inter-observer precision of UBPS. Results: The UBPS intra-operator reproducibilities were 5.3% and 6.1% (for the 1st and the
2nd operator, respectively), while inter-observer precision was 8.8%. Both AD-SoS
and UBPS significantly decreased in the non-user group (−0.7%, P < 0.001 and −14.3%, P < 0.001 respectively). In the user group AD-SoS showed a significant increase (+0.7%,
P < 0.01), while a slight but significant decrease was observed for UBPS (−2.8%, P < 0.05). Conclusions: Our findings show that the effectiveness of transdermal HRT in slowing or even arresting
postmenopausal bone loss can be monitored by quantitative US studies. The trend difference
observed between AD-SoS and UBPS with and without therapy is at least partially explained
by a different response to HRT with regard to bone density as well as structure.
Keywords
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Article info
Publication history
Accepted:
January 29,
1997
Received in revised form:
January 20,
1997
Received:
September 30,
1996
Identification
Copyright
© 1997 Published by Elsevier Inc.
