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

This research article investigated two different methods of hormone replacement therapy (HRT) on preventing bone loss in postmenopausal women. It compared the effects of continuous and sequential oral estrogen-progestogen regimens over a two-year period.

Objectives and Methodology

• The main goal of this study was to uncover which method, continuous or sequential hormone replacement therapy (HRT), demonstrates a greater efficacy in mitigating postmenopausal bone loss.
• In this study, 104 postmenopausal women were randomly placed into one of the two treatment groups. One group received a continuous regimen of Conjugated Equine Estrogens and Medroxyprogestin with no interruptions. The other group received a sequential regimen of Conjugated Equine Estrogens for 25 days, with the inclusion of Medroxyprogestin being added from the 14th day onward.
• The key metric of the study, bone mineral density (BMD), was measured at the start, after 12 months and again after 24 months by using dual energy X-ray absorptiometry.

Results and Findings

• The study discovered that both continuous and sequential regimens significantly improved bone density compared to the start of the study. However, there was no significant difference between the two regimens at the 12-month and 24-month check-ins.
• In the intention-to-treat analysis, both treatment groups also showed increases in BMD compared to the baseline values. However, the continuous regimen showed a greater increase in BMD at both the 12-month (3.5% vs 3%) and 24-month (5.5% vs 4.6%) check-ins than the sequential group.

Conclusions

• Based on the findings, the researchers concluded that the continuous administration regimen appears to be more effective in increasing bone density compared to the sequential regimen.
• Therefore, the study suggests that the continuous combination of estrogen therapy may be the most efficient approach for those women requiring long-term hormone replacement therapy.