Effect of daily hormone therapy and alendronate use on bone mineral density in postmenopausal women

Objective: To evaluate the effect of daily oral and transdermal hormone therapy alone or in combination with alendronate on bone mineral density in postmenopausal women. Design: Comparative prospective clinical study. Setting: Outpatient clinic of a training and research hospital. Patient(s): One hundred seventy-three consecutive postmenopausal women with no previous hormone therapy and a bone mineral density T score < -1 SD were randomly enrolled. Intervention(s): Oral conjugated estrogen, alone or with alendronate, or transdermal estrogen, alone or with alendronate, given for 1 year. All patients also received medroxyprogesterone acetate and calcium. Main Outcome Measure(s): Bone density measurement at L2 to 4 region by dual-energy X-ray absorptiometry. Results: At the end of 1 year, significant increase in bone density measurements were seen in all groups. Oral conjugated estrogen and transdermal estrogen have the same effect on bone mineral density loss. Hormone therapy alone stabilized the bone mineral density loss. Hormone therapy together with alendronate resulted in better values in all groups. Conclusion: Hormone therapy is adequate in osteopenic women. However, hormone therapy plus alendronate is advantageous in women with considerable bone mineral density loss.