The comparison of Tibolon and HRT on bone density and biochemical markers of bone turnover in post-menopausal women

Background and Objective: Menopause is one of the stages in women’s life with a lot of problems and osteoporosis as the most common of its complications. This study was designed to assess the comparative effects of tibolone and HRT on osteoporosis in postmenopausal healthy women. Tibolone is a synthetic steroid with estrogenic, progestogenic and androgenic properties.   Materials and Methods: A total of 107 women aged 45-64 years were randomly assigned to two groups: 52 women received 2.5 mg tibolone plus Ca-D daily 55 received 0.625 mg of conjugated equine estrogen plus 2.5 mg of medroxy progesterone acetate (CEE/MPA) plus Ca-D. At baseline and after 6 months of treatment, we measured bone turnover markers. Bone mineral density was measured in the spine and neck of femur by dual energy X- ray absorptiometry (DEXA) at baseline and after 9 months of treatment.  Results: ALP serum and Ca/Cr urinary decrease significantly in those taking tibolone and in those taking HRT.  T score, Z score and BMD increased significantly in the spine and femur in those taking tibolone. In those treated with conjugated equine estrogen and medroxy progesterone acetate T score, Z score and BMD in the spine and femur also increased significantly. No significant difference was observed between tibolone and CEE/MPA groups. Conclusion: Tibolone had beneficial effects on bone mineral density and bone turnover markers. It may be a good alternative to HRT in postmenopausal women who would not accept a vaginal bleeding and breast tenderness.