This study aimed at investigating the prevalence of osteopenia among a
hypoestrogenic group of patients with primary or secondary amenorrhea
. Twenty-seven patients with amenorrhea were examined. Sixteen of them
presented with secondary amenorrhea (mean age 28.8 +/- 1.9 yrs), and
11 with primary amenorrhea (mean age 21.3 +/- 1.6 yrs). Ten regularly
menstruating women (mean age 28.9 +/- 1.4 yrs) served as controls. Est
radiol serum levels as well as lumbar spine bone mineral density were
measured. All 11 patients with primary amenorrhea showed osteopenia wi
th a mean bone mineral density Z-score of 71 +/- 2% and mean estradiol
levels of 30.6 +/- 5.9 pg/ml. The secondary amenorrheic patients were
significantly demineralized with a mean Z-score of 82 +/- 3 %; 10 of
them had osteopenia. Their mean estradiol levels were 34.3 +/- 2.9 pg/
ml. The bone density in the primary amenorrheic patients was significa
ntly lower as compared with the secondary amenorrheic women. In compar
ison, lumbar spine bone density in all control women was normal with a
mean Z-score of 104 +/- 3 %. In summary, 21 of the 27 patients had os
teopenia, higher than that reported in post-menopausal women. Since it
is not proven whether the bone mineral deficit of amenorrheic patient
s can ever be compensated, early diagnostic steps and estrogen-progest
ogen replacement for the prevention of further bone loss and subsequen
t fractures are recommended.