Changes in bone density and bone metabolism in women with surgically induced menopause treated with a hormone replacement drug containing estradiol valerate and levonorgestrel
Abstract
A clinical study was performed to determine the effect of the sequential combined estrogen-progestogen drug Klimonorm (R) on changes in bone density and bone metabolism in 74 nonmenopausal women who underwent abdominal hysterectomy 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 17 beta -estradiol, estrone, osteocalcin, ionized calcium (Ca2+), ionized phosphate (PO42-), alkaline phosphatase, hemoglobin and hematocrit and urine concentrations of hydroxyproline, Ca2+ and PO42-. The BMD, T-score and Z-score were significantly reduced in women with surgical menopause.
Therapy with 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 decreased significantly to premenopausal values. The increased excretion of Ca2+ by urine during surgical menopause was significantly lowered during the therapy.
A shift to the lower step of bone disturbances was observed after 1 and 2 years of Klimonorm (R) administration.