Hormonal therapy fails to improve BMD in functional hypothalamic amenorrhea
Women with functional hypothalamic amenorrhea do not have significantly improved bone health with the use of hormonal therapy vs. placebo and calcium supplements, according to findings published in the Journal of the Endocrine Society.
Mohammad Hassan Murad, MD, MPH, division of preventive occupational and aerospace medicine at the Mayo Clinic, and colleagues conducted a systematic review and meta-analysis on nine studies evaluating the effect of hormonal therapy (estrogen therapy including oral contraceptive pills) in preventing bone loss in women with functional hypothalamic amenorrhea.
Overall, 280 women were included in the nine studies. Mean follow-up of the studies ranged from 8 to 48 months.
Control groups in the studies received no treatment, calcium supplements, placebo or placebo with calcium supplements.
Compared with participants in the control groups, participants receiving hormonal therapy had a statistically significant change in bone mineral density at the lumbar spine (weighted mean difference = 0.032 g/cm2 favoring hormonal therapy; weighted mean difference of percentage change in BMD = 3.3%) on the random-effects meta-analysis. There were no significant differences in BMD of the femoral neck, trochanteric region or Ward’s triangle or total body BMD between participants receiving hormonal therapy and participants in the control groups.
“The current evidence doesn’t support using hormonal therapy for the sole purpose of improving bone health in patients with [functional hypothalamic amenorrhea],” the researchers wrote. “There are no data about bisphosphonates in this population.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.