ESTROGEN-PROGESTOGEN REPLACEMENT THERAPY IN POSTMENOPAUSAL WOMEN - IS1-MG EXTRADIOLVALERATE SUFFICIENT TO MAINTAIN AXIAL TRABECULAR BONE-DENSITY

An oral estrogen-progestogen replacement therapy consisting of 1 mg es tradiolvalerate + 2 mg estriol/day for 21 days in combination with 0.2 5 mg levonorgestrel/day for the last 10 days sequentially may be suffi cient to maintain lumbar trabecular bone density in climacteric pre- a nd postmenopausal women as demonstrated by serial bone density measure ments (single-energy quantitative computed tomography of the lumbar sp ine) in 7 individuals with longitudinal follow-up for up to 5 years. A t present, only postmenopausal women with induced estradiol levels of at least greater-than-or-equal-to 220 pmol/l (greater-than-or-equal-to 60 pg/ml) provided by estrogen replacement therapies containing highe r daily estradiol doses as the above described preparation have been s hown to be protective against loss of trabecular bone at the lumbar sp ine. Preliminary pharmacokinetic results obtained from 14 post-menopau sal women being treated with the low-dose estrogen-progestogen replace ment demonstrated peak estradiol concentration of 120-160 pmol/l (32-4 3 pg/ml) 10 hours after oral ingestion, suggesting bone preserving pro perties by these considerably lower estradiol concentrations.