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Effects of Estrogen Replacement on Bone Geometry and Microarchitecture in Adolescent and Young Adult Oligo-amenorrheic Athletes- a Randomized Trial.

08:00 EDT 11th October 2019 | BioPortfolio

Summary of "Effects of Estrogen Replacement on Bone Geometry and Microarchitecture in Adolescent and Young Adult Oligo-amenorrheic Athletes- a Randomized Trial."

Oligo-amenorrheic athletes (OA) have lower bone mineral density (BMD) and greater impairment of bone microarchitecture, and therefore higher fracture rates compared to eumenorrheic athletes. While improvements in areal BMD (aBMD; measured by dual-energy x-ray absorptiometry) in OA have been demonstrated with transdermal estrogen treatment, effects of such treatment on bone microarchitecture are unknown. Here we explore effects of transdermal vs. oral estrogen vs. no estrogen on bone microarchitecture in OA. Seventy-five OA (ages 14-25 years) were randomized to (i) a 100 mcg 17β-estradiol transdermal patch (PATCH) administered continuously with 200 mg cyclic oral micronized progesterone, (ii) a combined 30 mcg ethinyl estradiol and 0.15 mg desogestrel pill (PILL), or (iii) no estrogen/progesterone (NONE) and were followed for 12 months. Calcium (≥1200 mg) and vitamin D (800 IU) supplements were provided to all. Bone microarchitecture was assessed using high resolution peripheral quantitative CT at the distal tibia and radius at baseline and one year. At baseline, randomization groups did not differ for age, body mass index, percent body fat, duration of amenorrhea, vitamin D levels, BMD, or bone microarchitecture measurements. After one year of treatment, at the distal tibial there were significantly greater increases in total and trabecular volumetric BMD (vBMD), cortical area and thickness, and trabecular number in the PATCH vs. PILL groups. Trabecular area decreased significantly in the PATCH group vs. the PILL and NONE groups. Less robust differences between groups were seen at the distal radius, where percent change in cortical area and thickness was significantly greater in the PATCH vs. PILL and NONE groups, and changes in cortical vBMD were significantly greater in the PATCH vs. PILL groups. In conclusion, in young oligo-amenorrheic athletes, bone structural parameters show greater improvement after one year of treatment with transdermal 17β-estradiol vs. ethinyl estradiol containing pills, particularly at the tibia. This article is protected by copyright. All rights reserved.

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This article was published in the following journal.

Name: Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
ISSN: 1523-4681
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