Changes in bone density and bone metabolism in women with surgically induced menopause treated with a hormone replacement drug containing estradiol valerate and levonorgestrel

A clinical study was performed to determine the effect of the sequential co mbined estrogen-progestogen drug Klimonorm (R) on changes in bone density a nd bone metabolism in 74 nonmenopausal women who underwent abdominal hyster ectomy with bilateral adnexectomy. The women started therapy with Klimonorm (R) 3-5 years after surgically induced menopause and it was continued for a period of 1-2 years. The following determinations were made: bone mineral density (BMD), T-score, Z-score, body mass index (BMI), plasma levels of 1 7 beta -estradiol, estrone, osteocalcin, ionized calcium (Ca2+), ionized ph osphate (PO42-), alkaline phosphatase, hemoglobin and hematocrit and urine concentrations of hydroxyproline, Ca2+ and PO42-. The BMD, T-score and Z-sc ore were significantly reduced in women with surgical menopause. Therapy wi th Klimonorm (R) significantly improved these indices. Plasma levels of 17 beta -estradiol and estrone increased considerably during the therapy. The plasma concentration of alkaline phosphatase increased significantly after surgically induced menopause, and during HRT with Klimonorm (R) it decrease d significantly to premenopausal values. The increased excretion of Ca2+ by urine during surgical menopause was significantly lowered during the thera py. A shift to the lower step of bone disturbances was observed after 1 and 2 years of Klimonorm (R) administration. (C) 2001 Prous Science. All right s reserved.