The technical and logistical feasibility of population densitometry using DXA and directed HRT intervention: A 2-year prospective study

The effects of short-term hormone replacement therapy on long-term bone mineral density

“…In the 1990s, the Centre for Metabolic Bone Disease at Hull Royal Infirmary commenced a feasibility study to investigate the logistics of population screening for osteoporosis 5 . All women in the local area aged 50-54 years were invited by letter for a BMD assessment by dualenergy X-ray absorptiometry (DXA) of the spine and hip using a Lunar DPX-L densitometer (GE Lunar, Madison, WI, USA).…”

“…Patients were blinded to the 2-year scan results. As such, those discontinuing HRT early did so due to intolerance rather than BMD changes; full reasons for discontinuation are described in the original study 5 . At each follow-up visit, a medical history was taken documenting general health, medications (including HRT) and clinical fractures.…”

“…The duration of treatment chosen for the Short-term HRT group was selected to represent patients who had received HRT for enough time to be able to detect a change in BMD (2 years) but less than the time taken for the incidence of breast cancer to differentiate from placebo in the WHI study 2 . The discontinuation rates and the reason for HRT discontinuation for this cohort of patients have previously been reported 5,6 .…”

The selective oestrogen receptor modulation: evolution and clinical applications

“…For these reasons it has been repeatedly observed that the acceptance of HRT is poor even among properly counselled women likely to benefit materially from its effects [ 18]. Hence as deliberate policy, a pharmacological research drive has now resulted in the first selective oestrogen receptor modulator (SERM) licensed for the prevention of bone loss, an effect apparently unaccompanied by the stimulation of such classical oestrogen‐sensitive tissues as breast and endometrium.…”

“…The drug was well tolerated and in particular there was no excess of mastalgia in the raloxifene 60 mg day −1 group nor of vaginal bleeding when compared with placebo treated controls. It should be noted that breast and uterine related side‐effects are the principal means for noncontinuation of conventional HRT therapy [ 18].…”