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• W2348795216 abstract "Objective To compare the long-term effects of treatment with cyclic percutaneous estradiol (1.5mg/d or 0.75mg/d) combined with two kinds of oral progestogen on bone loss in early postmenopausal women. Methods A 7-year open,randomized,parallel-group clinical trial was designed.The percutaneous 17β-estradiol(E_2) gel was used in a cyclic regimen combined with micronized progesterone(MP) or medroxyprogesterone acetate(MPA) for 7 years.60 early postmenopausal women were randomly assigned into 4 groups;G1:E_2 1.5 + MP100;G2;E_2 1.5 + MPA 2;G3:E_2 0.75 + MP 100;G4:E_2 0.75 + MPA 2(all doses in mg/d).All were given for 25 d/month,and 5 days free.Main measurements included bone mineral density(BMD) of L_(1-4) by quantitative computed tomography(every 2 years for 4 years),BMD of L_(2-4) and neck of femur(Neck) by dual energy X-ray absorptiometry(every 0.5 ~ 1 year for 7 years),radius bone mineral content(RBMC) and BMD of right radius(RBMD) by single photon absorptiometry(every year for 4 years).The vaginal bleeding,fracture,adverse effects were also recorded.Results(1) The BMD of all sites increased after treatment.The order of the percentage change of BMD in various parts from high to low in rums was L_(1-4),L_(2-4),Neck,RBMD.(2) L_(1-4) increased to its peak(+ 4.2%~ + 8.3%) at the 2nd year(P = 0.04);L_(2-4) increased gradually(+5.9%~ + 11.7%at the 7th year)(P0.0001);Neck increased gradually(+4.3%~ +4.6% at the 7th year)(P = 0.004);RMBC increased gradually in 4 years(+ 14.3%~ + 22.1%)(P0.0001);RBMD increased to its peak at the first 2-3 years(+0.6%~ +3.2%)(P =0.059).There was no significant between-group difference in the change of each indicator.(3) Compared with the groups with E_2 0.75mg/d,the groups with E_2 1.5mg/d had more percentage change in RBMC(P = 0.03) and L_(1-4),Neck and RBMD(P = 0.15 ~ 0.90).(4) Compared with the groups with MPA,the groups with MP had more percentage change in L_(1-4)、Neck,RBMC and RBMD (P = 0.27 ~0.98).(5) The occurrence of unscheduled vaginal bleeding in G1,G2,G3,G4 were 8.5%,32.27%, 7.46%and 14.86%,respectively(P0.002).(6) There were few fractures during the study.(7) There was no serious adverse effect during the treatment.Conclusion Both 0.75mg and 1.5mg percutaneous estradiol combined with different progestogen can prevent bone loss in early postmenopausal women.HT had more effect on trabecular BMD than cortical BMD.The effect of 1.5mg E_2 on the change of RBMC was better than 0.75 mg E_2.There was no difference in the effect on BMD between E_2 combined with MP and with MPA.The vaginal bleeding rate was low in the group with 0.75mg E_2,and when E_2 combined with 100 mg MP.We should consider individualized HT in clinical practice." @default.
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• W2348795216 date "2009-01-01" @default.
• W2348795216 modified "2023-09-27" @default.
• W2348795216 title "Effects of 7-year cyclic percutaneous estradiol combined with oral progestogen on bone loss in early postmenopausal women" @default.
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