Bone mineral density and broadband ultrasound attenuation with estrogen treatment of postmenopausal women

The purpose of the current study was to determine the changes in lumbar spi ne, hip, and calcaneus bone mineral density (BMD), and in calcaneus broadba nd ultrasound attenuation (BUA) in early menopausal women and to assess the effects of estrogen replacement therapy (ERT) on bone mass at these sites over a 2-yr period. Fifty-three Caucasian women who were at least 6 mo post menopausal were divided into two groups based on estrogen use. Twenty-one w omen, average age 53.0 +/- 0.6 yr and 2.9 +/- 0.3 yr since menopause, had b een receiving estrogen in combination with progesterone for at least 6 mo p rior to enrollment in the study. Thirty-two women, average age 52.7 +/- 0.8 yr and 2.8 +/- 0.3 yr since menopause, had never received ERT. During the 2-yr study, women not receiving ERT had significant decreases in BMD of the spine -2.3 +/- 0.6%, femoral neck -2.2 +/- 0.8%, and calcaneus -4.7 +/- 0. 9%, and in BUA of the calcaneus -14.3 +/- 1.8%. ERT prevented the decreases in BMD at the spine +0.4 +/- 0.6% and calcaneus -2.3 +/- 1.1%, but did not prevent a significant decrease in bone mass at the femoral neck -1.9 +/- 0 .8% and BUA at the calcaneus -17.8 +/- 3.2%. Neither group had significant decreases in total hip BMD. This study demonstrates again that ERT prevents the menopause-associated decreases in spine BMD. However, in this group of women, ERT did not prevent loss in femoral neck BMD or BUA. The results su ggest that women being treated with estrogen for maintenance of BMD in earl y menopause need to be monitored to ensure efficacy of therapy, especially in the maintenance of femoral neck BMD.