Does postmenopausal bone loss respond to estrogen replacement therapy independent of bone loss rate?

Bone loss in postmenopausal women can be treated by hormonal substitution therapy. We investigated whether rapid bone losers (as opposed to nonrapid losers) respond sufficiently to estrogen treatment. A sample of 88 early postmenopausal women was followed up for a 2-year observation period in which bone mineral content (BMC) was followed up every 3 months. From these data, 20 women were classified as rapid losers (bone loss greater than 3% per year) and 68 women as nonrapid losers. The women were allocated to treatment with estradiol in 4, 2, and 1 mg doses daily and followed up for 1 year. The mean response on BMC was dose-dependent, ranging from +1.6% per year with the 4 mg dose to -0.2% per year with the 1 mg dose. In none of the groups was there any difference in response between rapid and nonrapid losers. It is concluded that the BMC loss during observation in some participants (rapid losers) is considerable and that these participants respond in the same manner as nonrapid losers.