HRT a boon for young women with ovarian insufficiency

Hormone replacement helps to maintain normal bone mineral density (BMD) in young women with primary ovarian insufficiency (POI), a study by the National Institutes of Health (NIH) has found.

The randomized, double-blind, single-center, placebo-controlled clinical trial compared the effect of estradiol and progestin replacement (n = 72) versus estradiol, progestin, and testosterone replacement (n = 73) on BMD. The findings in this group were compared with a contemporaneous control group of normal women (n = 70).

BMD was measured using dual-energy x-ray absorptiometry of the hip and lower spine.

The researchers found that long-term transdermal estradiol replacement, in combination with oral medroxyprogesterone acetate, restored mean BMD to normal in young women with spontaneous POI. They also found that the addition of transdermal testosterone replacement did not provide additional benefit.

“Bone mineral density is an important measure of bone health. This study showed that not only could hormone treatment reduce the rate at which women with POI lose bone mineral density, but it could actually restore bone density to normal levels,” said Lawrence M. Nelson, MD, MBA, in an NIH press release.

“While hormone replacement therapy’s effect on bone mineral density ha s been studied in postmenopausal women, there is limited research on the effects of this therapy in younger women,” added lead author Vaishali B. Popat, MD. “This study provides important evidence that hormone replacement therapy with an appropriate dose of estradiol delivered via a skin patch combined with oral progestin can improve bone density to normal in women with [POI].”

The findings were published online in the Journal of Clinical Endocrinology & Metabolism.