Effect of continuous and sequential oral estrogen-progestogen replacement regimens on postmenopausal bone loss: a 2-year prospective study.

OBJECTIVE

The aim of the present study was to determine whether assignment to continuous estrogen-progestin therapy is more effective in protecting against bone loss than assignment to a sequential regimen.

STUDY

DESIGN

A total of 104 postmenopausal women were randomly assigned to one of two groups of treatment, Conjugated Equine Estrogens and Medroxyprogestin without interruption (continuous group) and Conjugated Equine Estrogens over 25 days with Medroxyprogestin beyond the 14th day (sequential group). Bone mineral density (BMD) was measured at inclusion, 12 and 24 months later by dual energy X-ray absorptiometry.

RESULTS

among women completing the 2-year treatment period, continuous and sequential regimens yielded results significantly different from baseline values, but not significantly different from each other at the 12-month (4.2 and 4%) or 24-month visits (6.6 and 6.3%). In the intention-to-treat analysis, the results with both regimens also differed from baseline values; additionally, the continuous group showed a greater increase in BMD than the sequential group at the 12-month (3.5 and 3%) and at the 24-month visits (5.5 versus 4.6%).

CONCLUSION

assignment to continuous administration seems to be more effective in increasing bone density than the sequential regimen. Thus, combined continuous estrogen therapy would seem to be the most effective regimen for those women requiring long-term hormone replacement therapy.