Effects of alendronate with or without hormone replacement therapy on bone mineral density in postmenopausal osteoporotic women

 Osteoporosis is an important problem in postmenopausal women. The use of best treatment is crucial to attaining appropriate therapeutic and prophylactic outcomes. Combination therapy versus single therapy may develop better results. This study was performed to determine the effects of alendronate alone versus plus hormone replacement therapy (HRT) on bone mineral density (BMD) in Iranian postmenopausal osteoporotic women.

 In this randomized clinical trial 200 consecutive postmenopausal osteoporotic women since 2018 to 2020 were enrolled and randomly assigned to receive either alendronate 70 mg alone or plus HRT 0.625 mg CEE and 2.5 mg medroxyprogesterone acetate. The improvement in BMD, hot flash, vaginal dryness, dyspareunia, and mood disorders was assessed after 12 months and compared across the groups. SPSS software by Kolmogorov-Smirnov, Chi-Square, and Mann-Whitney-U tests.

 Complete improvement in BMD was seen in 20 and 47 percent in single and combination groups, respectively with statistically significant difference (P=0.001). According to results, the improvements in hot flashes (P=0.048), vaginal dryness (P=0.001), dyspareunia (P=0.002), and mood disorders (P=0.001) in women were better in combination group.

 The addition of HRT to alendronate can increase the therapeutic effects on BMD and other symptoms in postmenopausal osteoporotic women and its use is recommended.