Prevention of early postmenopausal bone loss: controlled 2-year study in 315 normal females

Abstract With the aim of preventing postmenopausal bone loss, a placebo-controlled double-blind trial of 2 years duration was performed. We randomized 315 healthy volunteers in their early natural menopause to seven treatment and three placebo groups: 17β-oestra-diol, oestriol and sequential norethisteron (hormones); bendroflumethiazide 5 mg/day (thiazide); hormones and thiazide; sodium fluoride 20 mg/day; vitamin D3 2000 IU/day (D₃); fluoride and D₃; and lα (OH) vitamin D3 0–25 μg/day (lαD₃). All participants were given daily calcium supplement of 500 mg. Every 3 months we measured the bone mineral content (BMC) of both forearms by photon absorptiometry and chemical quantities in blood and 48 h urinary collections. The study was completed by 264 (84%).
The combined placebo groups snowed a linear fall in BMC reaching 3–3 % after 2 years ( P < 0–001). Hormones and hormones and thiazide led to a 2–5% gain in BMC ( P < 001). Thiazide alone postponed the BMC fall for 6 months. After 2 years the thiazide group showed a BMC fall of 1–5% ( P < 0–05), less than that of the placebo group ( P < 0–05). BMC declined by 3–6%, 4–5%, 3–7% and 3–7% during the respective use of fluoride, D₃, fluoride and D₃ and lαD₃. Nevertheless, the urinary calcium excretion during lαD₃ and D₃ treatment was 1–1–5 mmol/day higher than in the placebo groups.
Apparently, there is no real alternative to oestro-gen/gestagen in the prevention of postmenopausal osteoporosis.