Hormone replacement therapy (HRT) preserves bone mineral density (BMD) in most postmenopausal women, but there are variations in response. We studied the effects of continuous combined HRT, conjugate equine estrogen 0.625 mg/day and medroxy
progesterone
acetate 2.5mg/day, on spinal BMD in 29 postmenopausal women at 1 year interval. BMD was measured by dual photon absorptiometry.
There was an overall 4.1% gain in BMD after HRT. The response to HRT was greater in older postmenopausal women (n=7, mean age 69.3) who had atraumatic spinal fracture than women(n=22, mean age 50.1) who are less than 5 years from menopause (16.4%
VS
3.0%, p=0.03). The BMD was decreased 2.5% after HRT in women who had had pretreatment% young normal ≥90 but the BMD was increased 10.9% who had pretreatment % young normal < 90(p=0.013). Under HRT, 8 of 29 women (27.6%) who are less than 5 years
from
menopause have a 6% reduction in BMD after 1 year of HRT.
From the above results, it might be suggested that HRT appears to be more effective for older women with established osteoporosis than early postmenopausal women. Women with low BMD are likely better than women with high BMD.
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