In order to establish whether the favorable effect of estrogen therapy on postmenopausal bone loss was dose related, we measured sequential changes in the cortical diameters of the metacarpals by radiographic morphometry in 120 normal postmenopausal women who were being treated with ethinyl estradiol in doses ranging from 5 to 50 micrograms daily. There was a net loss of bone at doses below 15 micrograms per day and a net gain at doses of 25 micrograms per day and above. At doses between 15 and 25 micrograms daily, bone was neither gained nor lost. The loss of bone with the low doses was due to expansion of the medullary cavity that was unaccompanied by any change in total bone width. There was no change in bone volume with the intermediate doses because endosteal resorption of bone was offset by periosteal apposition. The net gain of bone with the higher doses occurred because endosteal resorption was totally inhibited but periosteal bone apposition continued. Thus, in postmenopausal women the reduction in the rate of cortical bone loss in response to estrogen therapy depends on the dose administered.
This article has been cited by other articles:
Wimalawansa, S. J., Grimes, J. P., Wilson, A. C., Hoover, D. R.
(2009). Transdermal Nitroglycerin Therapy May Not Prevent Early Postmenopausal Bone Loss. J. Clin. Endocrinol. Metab.
94: 3356-3364
[Abstract][Full Text]
Zheng, Y., Zhou, H., Modzelewski, J. R.K., Kalak, R., Blair, J. M., Seibel, M. J., Dunstan, C. R.
(2007). Accelerated Bone Resorption, Due to Dietary Calcium Deficiency, Promotes Breast Cancer Tumor Growth in Bone. Cancer Res.
67: 9542-9548
[Abstract][Full Text]
Liu, S L, Lebrun, C M
(2006). Effect of oral contraceptives and hormone replacement therapy on bone mineral density in premenopausal and perimenopausal women: a systematic review. Br. J. Sports. Med.
40: 11-24
[Abstract][Full Text]
Massai, R., Makarainen, L., Kuukankorpi, A., Klipping, C., Duijkers, I., Dieben, T.
(2005). The combined contraceptive vaginal ring and bone mineral density in healthy pre-menopausal women. Hum Reprod
20: 2764-2768
[Abstract][Full Text]
Wang, Q., Nicholson, P. H. F., Suuriniemi, M., Lyytikainen, A., Helkala, E., Alen, M., Suominen, H., Cheng, S.
(2004). Relationship of Sex Hormones to Bone Geometric Properties and Mineral Density in Early Pubertal Girls. J. Clin. Endocrinol. Metab.
89: 1698-1703
[Abstract][Full Text]
Grossman, J. M., MacLean, C. H.
(2001). Quality Indicators for the Management of Osteoporosis in Vulnerable Elders. ANN INTERN MED
135: 722-730
[Full Text]
Blom, M. J., Wassink, M. G., van Wijk, F., Ederveen, A. G. H., Kloosterboer, H. J., Verhoeven, C. H. J., Lambert, J. G. D., Th. Goos, H. J.
(2001). Metabolism of Norethisterone and Norethisterone Derivatives in Rat Uterus, Vagina, and Aorta. Drug Metab. Dispos.
29: 976-982
[Abstract][Full Text]
Blom, M. J., Wassink, M. G., Kloosterboer, H. J., Ederveen, A. G. H., Lambert, J. G. D., Th. Goos, H. J.
(2001). Metabolism of Estradiol, Ethynylestradiol, and Moxestrol in Rat Uterus, Vagina, and Aorta: Influence of Sex Steroid Treatment. Drug Metab. Dispos.
29: 76-81
[Abstract][Full Text]
Recker, R. R., Davies, K. M., Dowd, R. M., Heaney, R. P.
(1999). The Effect of Low-Dose Continuous Estrogen and Progesterone Therapy with Calcium and Vitamin D on Bone in Elderly Women: A Randomized, Controlled Trial. ANN INTERN MED
130: 897-904
[Abstract][Full Text]
Michaëlsson, K., Baron, J. A, Farahmand, B. Y, Johnell, O., Magnusson, C., Persson, P.-G., Persson, I., Ljunghall, S.
(1998). Hormone replacement therapy and risk of hip fracture: population based case-control study. BMJ
316: 1858-1863
[Abstract][Full Text]
Genant, H. K., Lucas, J., Weiss, S., Akin, M., Emkey, R., McNaney-Flint, H., Downs, R., Mortola, J., Watts, N., Yang, H. M., Banav, N., Brennan, J. J., Nolan, J. C.
(1997). Low-Dose Esterified Estrogen Therapy: Effects on Bone, Plasma Estradiol Concentrations, Endometrium, and Lipid Levels. Arch Intern Med
157: 2609-2615
[Abstract]
Sumner, W. II
(1994). Four Proposals for Market-Based Health Care System Reform. Arch Fam Med
3: 660-664
[Abstract]
Kadel, N. J., Teitz, C. C., Kronmal, R. A.
(1992). Stress fractures in ballet dancers. Am J Sports Med
20: 445-449
[Abstract]
(1992). Diagnostic and Therapeutic Technology Assessment (DATTA). JAMA
267: 286-294
Harris, S. T., Genant, H. K., Baylink, D. J., Gallagher, J. C., Karp, S. K., McConnell, M. A., Green, E. M., Stoll, R. W.
(1991). The Effects of Estrone (Ogen) on Spinal Bone Density of Postmenopausal Women. Arch Intern Med
151: 1980-1984
[Abstract]
Tosteson, A. N. A., Rosenthal, D. I., Melton, L. J. III, Weinstein, M. C.
(1990). Cost Effectiveness of Screening Perimenopausal White Women for Osteoporosis: Bone Densitometry and Hormone Replacement Therapy. ANN INTERN MED
113: 594-603
[Abstract]
Komm, B., Terpening, C., Benz, D., Graeme, K., Gallegos, A, Korc, M, Greene, G., O'Malley, B., Haussler, M.
(1988). Estrogen binding, receptor mRNA, and biologic response in osteoblast-like osteosarcoma cells. Science
241: 81-84
[Abstract]
SOLOMON, D. H., JUDD, H. L., SIER, H. C., RUBENSTEIN, L. Z., MORLEY, J. E.
(1988). New Issues in Geriatric Care. ANN INTERN MED
108: 718-732
[Abstract]
Cook, S. D., Harding, A. F., Thomas, K. A., Morgan, E. L., Schnurpfeil, K. M., Haddad, R. J. JR
(1987). Trabecular bone density and menstrual function in women runners. Am J Sports Med
15: 503-507
[Abstract]
Horowitz, M., Wishart, J., Need, A. G., Morris, H., Philcox, J., Nordin, B. E. C.
(1987). Treatment of Postmenopausal Hyperparathyroidism With Norethindrone: Effects on Biochemistry and Forearm Mineral Density. Arch Intern Med
147: 681-685
[Abstract]
ETTINGER, B., GENANT, H. K., CANN, C. E.
(1987). Postmenopausal Bone Loss Is Prevented by Treatment with Low-Dosage Estrogen with Calcium. ANN INTERN MED
106: 40-45
[Abstract]
CUMMINGS, S. R., BLACK, D.
(1986). Should Perimenopausal Women Be Screened for Osteoporosis?. ANN INTERN MED
104: 817-823
[Abstract]
