Bone Ailment in Women May Be Reversed

Loss of bone mass in women suffering from one of the most common types of amenorrhea, a condition in which menstruation stops, can be partly reversed by restoring the normal monthly cycle, doctors reported Wednesday.

Many women suffering a form of the condition known as hyperprolactinemic amenorrhea who are treated with drugs or surgery to restore their cycles may also show an increase in bone density, the researchers said. Their study was published in today’s issue of the New England Journal of Medicine.

Before treatment, “many of these women showed evidence of significant loss in bone density to the degree that it may make them susceptible to bone fractures in future years,” said Dr. Anne Kilbanski of Massachusetts General Hospital’s thyroid unit.

Elevated Hormone Level

Amenorrhea affects between 1.8% and 3.3% of young women. About 30% of these have elevated levels of prolactin, a hormone that stimulates lactation.

Amenorrhea can be related to excessive exercise, weight loss or premature menopause, all of which are linked to estrogen deficiency. These women may also suffer osteoporosis, but it is not known whether it is progressive in untreated patients or whether it can be reversed by restoring normal ovarian function.

Kilbanski said 32 women with hyperprolactinemic amenorrhea, many of whom also were deficient in estrogen, were studied for 12 to 72 months.

Fourteen untreated patients were studied to determine the effect of having elevated prolactin levels for an extended period, and 18 who received treatment were followed to determine the effect of restored menstruation on bone mass.

Bone Density Measured

The density of the bones in the women’s wrists was measured four to six times throughout the study.

Among those who were treated, most but not all patients experienced significant increases in bone density within six to 12 months after treatment but densities remained below normal.

However, some women--despite therapy and normalization of prolactin levels--did not show an improvement in bone density levels. Bone mass remained stable in 29% of the untreated patients.