Prevention of bone loss following oophorectomy in premenopausal women: a retrospective assessment of the effects of oophorectomy and a prospective controlled trial of the effects of mestranol therapy

Abstract

Prospective studies of bone mass in women following oophorectomy for benign conditions were done by the double-blind technique. Skeletal response to treatment was measured by photon absorption densitometry. Untreated patients were found to lose bone mass rapidly during the first two years after oophorectomy. When estrogen replacement was started within two months of oophorectomy, it was found to be effective in preventing subsequent bone tissue loss. Three years following oophorectomy, untreated women who had already lost bone tissue, and who were then started on estrogen replacement, showed a highly significant increase in their bone mass. The women in whom this treatment was delayed for six years did not respond. No untoward effects were noted in these women, perhaps, in part, because they had undergone hysterectomy. Long-term effects of this treatment are now being evaluated.

PIP: A double-blind prospective study was conducted to assess the effect of mestranol therapy on bone loss following cophorectomy in 258 premenopuasal women. Photon absorpotion densitometry was employed to measure the skeletal response to treatment. Patients who were not treated rapidly lost bone mass during the 1st 2 years after the operation. Initiation of mestranol therapy within 2 months of oophorectomy effectively prevented subsequent bone loss (p less than .05). When replacement therapy was initiated 3 years after cophorectomy, women who had already shown bone loss exhibited a higly signifcant (p less than .005) increase in bone mass. However, there was no positve response if treatment was delayed for 6 years. There were no serious side effects, perhaps, in part, because hysteretomy had also been performed.