The effect of continuous oestradiol with intermittent norgestimate on bone mineral density and bone turnover in post-menopausal women

Novel actions of progesterone: what we know today and what will be the scenario in the future?

“…In conclusion, estradiol is effective in the treatment of osteoporosis [97,98] HRT regimen of continuous estradiol with intermittent norgestimate deceased bone turnover, [121] hormonal contraceptives are considered safe [103] regarding bone loss in long‐term users and though there are small changes in BMD after initiation of use these are reversible (WHO, multicentre study), [101] and progestin‐only contraception may have a detrimental effect on BMD, [123–125] especially in first‐ever users of depot medroxyprogesterone acetate [126] (before using any oral contraceptives), [127] or may not have detrimental effects, [102,128] leading to controversy. Thus, for prescribing contraception, it is important to take this into account for the sake of bone protection [127] .…”

“…[97] Another study showed the continuous estradiol/intermittent norgestimate HRT regimen to be well tolerated and to reduce bone loss in healthy post-menopausal women. [121] In comparison with alendronate, a bisphosphonate, the combination of estradiol and norethisterone acetate showed better results in the context of BMD in hip, spine and total body ( Figure 4). [122] In conclusion, estradiol is effective in the treatment of osteoporosis [97,98] HRT regimen of continuous estradiol with intermittent norgestimate deceased bone turnover, [121] hormonal contraceptives are considered safe [103] regarding bone loss in long-term users and though there are small changes in BMD after initiation of use these are reversible (WHO, multicentre study), [101] and progestin-only contraception may have a detrimental effect on BMD, [123][124][125] especially in firstever users of depot medroxyprogesterone acetate [126] (before using any oral contraceptives), [127] or may not have detrimental effects, [102,128] leading to controversy.…”

“…Overall, past studies have pointed to the good efficacy of norethisterone acetate, but recent studies contradict this [97] . Another study showed the continuous estradiol/intermittent norgestimate HRT regimen to be well tolerated and to reduce bone loss in healthy post‐menopausal women [121] …”

Long-Term Drug Therapy and Drug Holidays for Osteoporosis Fracture Prevention: A Systematic Review

“…Nine eligible publications of three unique studies compared long-term alendronate treatment versus placebo, no treatment or a different active treatment, and reported on risk of incident fractures. We rated four of these studies as having high risk of bias (ROB) [48][49][50][51] and extracted only limited data (Appendix D). For the remaining five studies with low or medium ROB, 32,35,36,39,40 additional information was extracted in evidence tables and SOE summary tables, available in Appendix D.…”

“…Fourteen eligible publications of eleven unique studies compared long-term alendronate treatment versus placebo, no treatment or a different active treatment, and reported on risk of harms. We rated four of these studies as having high ROB 47,[50][51][52] and extracted only limited data (Appendix Table D7). For the remaining ten studies with low or medium ROB, there were four eligible publications from one unique RCT with low 35,43 and medium 31,38 ROB, respectively, and six observational studies with medium ROB.…”