{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T17:43:07Z","timestamp":1765474987491,"version":"3.48.0"},"reference-count":21,"publisher":"BMJ","issue":"6644","license":[{"start":{"date-parts":[[1988,7,30]],"date-time":"1988-07-30T00:00:00Z","timestamp":586224000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1988,7,30]]},"abstract":"<jats:p>STUDY OBJECTIVE--To compare oral and implanted oestrogens for their effects in preventing postmenopausal osteoporosis. DESIGN--Non-randomised cohort study of postmenopausal women treated with oral or depot oestrogens and postmenopausal controls. SETTING--Gynaecological endocrine clinic in tertiary referral centre. PATIENTS--Oral treatment group of 37 postmenopausal women (mean age 57.5 years, median 8.75 years from last menstrual period), compared with 41 women given oestrogen implants (mean age 56.2 years, median 9.5 years from last menstrual period) and 36 controls (mean age 51.8 years, median 2.0 years from last menstrual period). Weight was not significantly different among the groups. INTERVENTIONS--Oral treatment group was given continuous treatment with cyclic oestrogen and progesterone preparations (Prempak C or Cycloprogynova) for a median of 8.0 years. Implant group was given subcutaneous implants of oestradiol 50 mg combined with testosterone 100 mg, on average six monthly for a median of 8.5 years. Controls were not treated. END POINT--Significant increase in bone density. MEASUREMENTS AND MAIN RESULTS--Bone density measured by dual beam photon absorptiometry was 1.02 (SD 0.13) g hydroxyapatite\/cm2 in implant group versus 0.89 (0.11) in oral group (p less than 0.01) and 0.87 (0.14) in controls (p less than 0.01). Serum oestradiol concentration in implant group was (median) 725 pmol\/l versus 170 pmol\/l in oral group (p less than 0.01) and 99 pmol\/l in controls (p less than 0.01). Serum follicular stimulating hormone was median 1 IU\/l (range 1-11) in implant group (equivalent to premenopausal values) versus 43 (4-94) IU\/l in oral group (p less than 0.01) and 72 (28-99) IU\/l in controls (p less than 0.01). CONCLUSIONS--Subcutaneous oestrogen is more effective than oral oestrogen in preventing osteoporosis, probably owing to the more physiological (premenopausal) serum oestradiol concentrations achieved. It also avoids problems of compliance that occur with oral treatment.<\/jats:p>","DOI":"10.1136\/bmj.297.6644.331","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"331-333","source":"Crossref","is-referenced-by-count":70,"title":["Skeletal effects of oral oestrogen compared with subcutaneous oestrogen and testosterone in postmenopausal women."],"prefix":"10.1136","volume":"297","author":[{"given":"M.","family":"Savvas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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Long term prevention of postmenopausal osteoporosis by oestrogen. Lancet 1976;i: 1038-4 1.","journal-title":"Lancet"},{"key":"ref_2","first-page":"277","article-title":"Estrogen replacement therapy: a ten year prospectise studs in the relationship to osteopotrosis","volume":"53","author":"Nachtigall, L.E.; Nachtigall, R.H.; Nachtigall, R.D.; Beckman, E.M.","year":"1979","unstructured":"Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy: a ten year prospectise studs in the relationship to osteopotrosis. Obstet G(vniecol 1979;53:277-81.","journal-title":"Obstet G(vniecol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S0140-6736(81)91848-1","article-title":"Transbol 1. Bone mass in postmenopausal women after withdrawal of oestrogen\/gestagen replacement therapy","volume":"i:","author":"Christiansen, C.; Christiansen, M.S.","year":"1981","unstructured":"Christiansen C, Christiansen MS, Transbol 1. Bone mass in postmenopausal women after withdrawal of oestrogen\/gestagen replacement therapy. Lancet 1981;i:459-61.","journal-title":"Lancet"},{"key":"ref_4","first-page":"129","article-title":"Hormonal treatment, selection of patients-kind and duration of treatment. In: Greenblatt RB, de Gruyter W', eds. A modern approach to the mentopause","author":"Studd, J.W.W.; Anderson, H.M.; Montgomerv, J.C.","year":"1986","unstructured":"Studd JWW, Anderson HM, Montgomerv JC. Hormonal treatment, selection of patients-kind and duration of treatment. In: Greenblatt RB, de Gruyter W', eds. A modern approach to the mentopause. Berlin: de Gruvter, 1986: 129-40."},{"key":"ref_5","first-page":"648","article-title":"Procedures in practice: hormone implantation","volume":"i:","author":"Thom, M.; JW'W, Studd","year":"1980","unstructured":"Thom M, Studd JW'W. Procedures in practice: hormone implantation. Br Med_7 1980;i:648-50."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S0889-8545(21)00581-7","article-title":"Hormone pellet implantation for the menopause and premenstrual tension","volume":"14","author":"Studd, J.W.W.; Magos, A.L.","year":"1987","unstructured":"Studd JWW, Magos AL. Hormone pellet implantation for the menopause and premenstrual tension. Obsoet Gs,vttecol Chln North Am 1987;14:229-49.","journal-title":"Obsoet Gs, vttecol Chln North Am"},{"key":"ref_7","first-page":"182","article-title":"Oestrogens and endometrial carcinoma","volume-title":"in obstetrics and gynaecology. V'ol 1","author":"Studd, J.W.W.; Thom, M.","year":"1981","unstructured":"Studd JWW, Thom M. Oestrogens and endometrial carcinoma. In: Studd JWWX, ed. I'rogress in obstetrics and gynaecology. V'ol 1. London: Chtlrchill Lisingstone, 1981:182-98."},{"key":"ref_8","first-page":"105","article-title":"IPhoton-bcam absorptiormetrr","volume-title":"Symposium No 55, International Congress of the Royal Society of Medicine; multidisciplinarv problem","author":"Neilsen, S.P.; Krolner, B.L.","year":"1983","unstructured":"Neilsen SP, Krolner BL. IPhoton-bcam absorptiormetrr. In: Dixan ASJ, Russell RGG, Stamp TCB, eds. Osteoporosis-a multidisciplinarv problem. Symposium No 55, International Congress of the Royal Society of Medicine. London: Acadetitc IPress, 1983:105-8."},{"key":"ref_9","first-page":"453","article-title":"Bone mineral measurements in clinical practice","volume":"37","author":"Murby, B.; Fogelman, I.","year":"1987","unstructured":"Murby B, Fogelman I. Bone mineral measurements in clinical practice. Br.7 Hosp Med 1987-;37:453-8.","journal-title":"Br.7 Hosp Med"},{"key":"ref_10","first-page":"321","article-title":"Long term hormone implant therapy-hormonal and clinical effects","volume":"67","author":"Barlow, E.H.; Abdulla, H.I.; Roberts, A.D.G.; Al Azzawi, F.; Leggate, I.; Hart, D.M.","year":"1986","unstructured":"Barlow EH, Abdulla HI, Roberts ADG, Al Azzawi F, Leggate I, Hart DM. Long term hormone implant therapy-hormonal and clinical effects. Obstet Gvnecol 1986;67:321-5.","journal-title":"Obstet Gvnecol"},{"key":"ref_11","first-page":"759","article-title":"The minimum effective dose of estrogen for the prevention of post-menopausal bone loss","volume":"63","author":"Lindsay, R.; Hart, D.M.; Clark, D.M.","year":"1984","unstructured":"Lindsay R, Hart DM, Clark DM. The minimum effective dose of estrogen for the prevention of post-menopausal bone loss. 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