Progesterone and Bone: Actions Promoting Bone Health in Women

Table 4

Comparison of randomized double-blind controlled trials of bone change in postmenopausal women with osteoporosis comparing combined estrogen [Conjugated Equine Estrogen (CEE) or Estradiol (E₂)] plus progesterone or medroxyprogesterone (MPA) and documenting percentage (%) change per year in Bone Mineral Density.

Author	Type	Number	Age $\pm$ SD	Bone sites	Years	Anti-resorptive mg/d	Progesterone/; MPA mg/d	Number	Combined % bone change	Number	Anti-R* % bone change
Gallagher 1991 [84]	RCT not blinded	81	52 $\pm$ 4	DPA; L2$-$4; SPA	2	0.3 CEE; 23/28 days	MPA 10 mg; 23/28 days	16	Spine $+$0.25	18	Spine $+$1.0
				Radius					Radius $+$0.0		Radius $-$0.05
PEPI 1996 [89]	DB-RCT	875	56	DXA; L2$-$4	3	CEE 0.625	MPA 2.5 mg/d	174	Spine $+$1.6	175	Spine $+$1.4
				Total Hip (TH)				174	TH $+$0.5	175	TH $+$0.5
Adachi 1997 [91]	DB-RCT	98	54	DPA	1	CEE 0.625	MPA 10 mg for 15 d/mo.	33	Spine $+$2.7	34	Spine +1.9
Lindsay 2002 [90]	DB-RCT	695	58	L2$-$4; DXA	2	CEE 0.625	MPA 2.5 mg/d	81	Spine $+$1.7	84	Spine $+$1.2
				Total Hip (TH)					TH $+$1.3		TH $+$1.4
						CEE 0.45	MPA 2.5 mg/d	87	Spine $+$1.5	91	Spine $+$1.1
									TH $+$1.1		TH $+$1.0
Liu 2005 [87]	DB-RCT	132	53	DXA; L2$-$4	2	E2 1 mg/d	MPA 10 mg/d	20	Spine $+$2.3	23	Spine $+$1.3
				FN		OME^#			FN $+$0.9		FN $+$1.0
$\text{Totals}\widehat{\hspace{0.17em}\hspace{0.17em}}$								330	Spine +1.7	425	Spine $+$1.3

${}_{}{}^{\bullet }\text{DPA}$: dual photon absorptiometry, SPA: single photon absorptiometry, DXA: dual energy X-ray absorptiometry.
*Anti-R: antiresorptive therapy, ^#OME: oral micronized estradiol.
$\widehat{\hspace{0.17em}\hspace{0.17em}}$Note that the two estrogen-dose arms of the Lindsay study were considered as two different studies in the mean spine bone change.