Long-term follow-up of bone density in women with primary ovarian insufficiency

Objective: This study aims to analyze long-term variation in bone mineral density among young women with primary ovarian insufficiency. Methods: A cohort study evaluated bone mineral density in 72 women with primary ovarian insufficiency who were receiving estrogen + progestogen therapy. Bone mineral density was evaluated every 2 years for 8 years. Results: The women were young, with a mean (SD) age of 34.1 (6.7) years and had a bone density measurement at baseline. The mean (SD) time between the last menstruation and the beginning of hormone treatment was 2.9 (4.2) years. The initial mean (SD) bone mineral density was 1.03 (0.17) and 0.91 (0.16) g/cm(2) for the lumbar spine and femoral neck, respectively. The mean (SD) T score was -1.03 (1.39) and -0.29 (1.09) for the lumbar spine and femoral neck, respectively. Bone mineral density measurements after a follow-up period of 2, 4, 6, and 8 years did not differ from bone mineral density at baseline. Osteopenia and osteoporosis were observed at the lumbar spine and femoral neck in 46% and 25% of women at the time of diagnosis, with no difference in the percentage of affected women across time. Conclusions: Although women with primary ovarian insufficiency who are receiving estrogen + progestogen therapy maintain stable bone mass throughout an 8-year follow-up period, this treatment is not sufficient to decrease the number of women who experience some level of low bone density. Therapeutic regimens should be reviewed, probably with resumption of discussions about the need for other therapeutic strategies.