Journal of the Chinese Medical Association
Volume 70, Issue 5 , Pages 200-206, May 2007

A Clinical Trial of 3 Doses of Transdermal 17β-estradiol for Preventing Postmenopausal Bone Loss: A Preliminary Study

  • Tzay-Shing Yang

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Tzay-Shing Yang, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Yi-Jen Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Wei-Hsing Liang

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Cheng-Yen Chang

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Ling-Chen Tai

      Affiliations

    • Statistics Team, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Sheng-Pin Chang

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Heung-Tat Ng

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 20 April 2006; accepted 19 March 2007.

Article Outline

Background

It is well documented that a daily oral dose of 0.625 mg of conjugated equine estrogen or 1-2 mg of 17β-estradiol is needed to prevent postmenopausal bone loss. Recent studies have indicated that a lower dose of estrogen may be as effective in maintaining bone mass. The purpose of this study was to evaluate the effects of 3 dosages of transder-mally administered 17β-estradiol gel in postmenopausal women stratified by oophorectomy and natural menopause.

Methods

One hundred and twenty postmenopausal women were randomly selected to form 4 groups. Three groups of women were treated with a transdermal administration of estradiol gel at a daily dosage of 1.25, 2.5 and 5.0 g (containing 0.75, 1.5, and 3 mg of 17β-estradiol/day), respectively. The 4th group of women, receiving estriol 2 mg/day p.o., was studied concurrently as a control. Bone mineral density was measured by quantitative computed tomography of the vertebrae from T12 to L3 at baseline, then at 6-month intervals for 1 year.

Results

Women in all groups receiving 17β-estradiol gel obtained a significant increase in bone mass, with the exception of the 1.25 g/day group, which showed a minimal increment at the 6-month period, compared with the control group. Comparisons of the increments in bone mass after estrogen therapy for both natural and surgical menopausal subjects found that there was a more prominent response in surgical menopausal women receiving a dosage of 2.5 g/day.

Conclusion

Estradiol gel at the dosage of 1.25 g/day, equivalent to 17β-estradiol 0.75 mg/day, effectively prevented bone loss in postmenopausal women after a 12-month treatment period. The therapeutic effect of estrodiol gel on bone mass was more prominent in the surgical menopausal groups at the dosage of 2.5 g/day. The atrophic ovaries may therefore play a crucial role in the subsequent decades of postmenopausal women.

Key Words:  bone mineral density , effective low dose , estradiol gel , menopause , oophorectomy , quantitative computed tomography

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PII: S1726-4901(09)70358-2

doi:10.1016/S1726-4901(09)70358-2

Journal of the Chinese Medical Association
Volume 70, Issue 5 , Pages 200-206, May 2007

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