SynthesisJournal of musculoskeletal & neuronal interactions2017
Estrogen-progestin therapy causes a greater increase in spinal bone mineral density than estrogen therapy - a systematic review and meta-analysis of controlled trials with direct randomization.
Synthesis in Journal of musculoskeletal & neuronal interactions, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Impact of menopause hormone therapy, exercise, and their combination on bone mineral density and mental wellbeing in menopausal women: a scoping review.Frontiers in reproductive health · 2025Pooled it
- Using a Composite Summary of Daily Sex Hormones to Gauge Time Until Menopause: A Focus on Pregnanediol Glucuronide (PDG).The Journal of clinical endocrinology and metabolism · 2025Article
- Exploring the Interaction Between Sjögren's Syndrome and Osteoporosis: Pathophysiological Mechanisms and Management Strategies.International journal of general medicine · 2025Review
- Association of Hormonal Exposures With Grip Strength in Women >45 Years: Data From the CONSTANCES Cohort Study.Journal of the Endocrine Society · 2024Article
- Diagnostic and therapeutic use of oral micronized progesterone in endocrinology.Reviews in endocrine & metabolic disorders · 2024Review
- Role of ubiquitination in the occurrence and development of osteoporosis (Review).International journal of molecular medicine · 2024Review
- A Prediction Model for Osteoporosis Risk Using a Machine-Learning Approach and Its Validation in a Large Cohort.Journal of Korean medical science · 2023Article
- Perimenopausal Bone Loss Is Associated with Ovulatory Activity-Results of the PeKnO Study (Perimenopausal Bone Density and Ovulation).Diagnostics (Basel, Switzerland) · 2022Article
- The Evaluation of Xiaozeng Qianggu Tablets for Treating Postmenopausal Osteoporosis via up-Regulated Autophagy.Evidence-based complementary and alternative medicine : eCAM · 2022Article
- Adaptive, reversible, hypothalamic reproductive suppression: More than functional hypothalamic amenorrhea.Frontiers in endocrinology · 2022Article
- The Relationship Between Bone and Reproductive Hormones Beyond Estrogens and Androgens.Endocrine reviews · 2021Review
- The Human Gut Microbiota: A Key Mediator of Osteoporosis and Osteogenesis.International journal of molecular sciences · 2021Review
- Estrogen and bones after menopause: a reappraisal of data and future perspectives.Hormones (Athens, Greece) · 2021Review
- MicroRNA expression profiling in an ovariectomized rat model of postmenopausal osteoporosis before and after estrogen treatment.American journal of translational research · 2020Article
- Update on Menopausal Hormone Therapy for Fracture Prevention.Current osteoporosis reports · 2019Review
- Observational
- Innovations in Women's Bone Health-Appreciating Important "Bone Variables" Besides Estrogen.International journal of environmental research and public health · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess whether progesterone (P4) or osteoblast P4 receptor-acting progestin (P) contributed to estrogen (E) therapy-related increased areal bone mineral density (BMD) in randomized controlled trials (RCT) with direct randomization to estrogen (ET) or estrogen-progestin (EPT) therapy.
methodsSystematic literature searches in biomedical databases identified RCT with direct randomization and parallel estrogen doses that measured spinal BMD change/year. Cyclic P4/P was included in this random effects meta-analysis only if for ≥ half the number of E-days.
resultsSearches yielded 155 publications; five met inclusion criteria providing eight dose-parallel ET-EPT comparisons in 1058 women. Women averaged mid-50 years, ⟨five years into menopause and took conjugated equine E daily at 0.625 mg with/without 2.5 mg medroxyprogesterone acetate (MPA). The weighted mean EPT minus ET percentage difference in spinal BMD change was +0.68%/year (95% CI 0.38, 0.97%) (P=0.00001). This result was highly heterogeneous (I²=81%) but this may reflect the small number of studies.
conclusionEstrogen with an osteoblast P4R-acting progestin (EPT) in these five published RCT provides Level 1 evidence that MPA caused significantly greater annual percent spinal BMD gains than the same dose of ET. These data have implications for management of vasomotor symptoms and potentially for osteoporosis treatment in menopausal women.
Indexed as
Identifiers
28860416PMC5601259W2990383685What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.