1. Home>
2. Specialties>
3. General Medicine>
4. Summary and Comment

EXERCISE PLUS HORMONE THERAPY PREVENTS BONE LOSS AFTER MENOPAUSE.

Exercise, calcium supplementation, and combined estrogen and progestin therapy have all been proposed as prophylactic measures against osteoporosis and consequent fractures in postmenopausal women. A two-year, double-blind trial from Australia compared the three approaches.

Researchers randomized 120 women with low forearm bone density to exercise only (one exercise class and two brisk 30-minute walks per week), exercise plus calcium (1 g per day), or exercise plus continuous replacement of estrogen and progesterone. A comparison group of 42 women with normal forearm bone density received no therapy.

The comparison and exercise-only groups, respectively, lost 2.7 percent and 2.6 percent of bone density in the distal forearm per year. In contrast, the exercise-plus- calcium group lost only 0.5 percent and the exercise-plus- hormone group gained 2.7 percent. The hormone-treated group had significantly more breast tenderness and vaginal bleeding than the other groups, but had significantly fewer hot flashes, less dyspareunia, and less sleeplessness.

This study convincingly shows that exercise plus continuous estrogen and progestin therapy is more effective than the other regimens at retarding bone loss in women at high risk for osteoporosis. These data will help physicians and patients decide whether and how to protect against this condition.

— ALK

Published in Journal Watch General Medicine October 25, 1991

Citation(s):

Prince RL et al. Prevention of postmenopausal osteoporosis -- a comparative study of exercise, calcium supplementation, and hormone-replacement therapy. N Engl J Med 1991 Oct 24 325 1189-1195.

• Medline abstract (Free)