T. Naessen et al., BONE LOSS IN ELDERLY WOMEN PREVENTED BY ULTRALOW DOSES OF PARENTERAL 17-BETA-ESTRADIOL, American journal of obstetrics and gynecology, 177(1), 1997, pp. 115-119
OBJECTIVES: Our purpose was to assess whether an ultralow dose of pare
ntal estradiol, aimed for treatment of vaginal atrophy, affects bone m
etabolism and bone density. STUDY DESIGN: Thirty healthy women greater
than or equal to 60 years old were randomly assigned to a 6-month tre
atment with either an ultralow dose of parenteral estradiol (7.5 mu g/
24 hours) delivered by vaginal rings or no treatment in the proportion
2:1. RESULTS: Forearm bone density increased in estradiol users by 2.
1% (95% confidence interval 0.4 to 3.8, p = 0.008), contrasting to a d
ecrease in nonusers of -2.7% (95% confidence interval -5.9 to 0.4, p =
0.077). In analysis of variance the changes in the two study groups d
iffered significantly (p = 0.0004). Consistently, serum alkaline phosp
hatases, bone-specific alkaline phosphatases, and osteocalcin concentr
ations decreased in the treatment group (8%, p = 0.019; 14%, p = 0.000
6; and 9%, p = 0.02, respectively), suggesting reduced bone turnover.
No significant changes were found in nonusers. CONCLUSION: Ultralow do
ses of estradiol may potentially prevent bone loss in women greater th
an or equal to 60 years old.