Abstract
This study aimed at investigating the prevalence of osteopenia among a hypoestrogenic
group of patients with primary or secondary amenorrhea. Twenty-seven patients with
amenorrhea were examined. Sixteen of them presented with secondary amenorrhea (mean
age 27.8 ± 1.9 yrs), and 11 with primary amenorrhea (mean age 21.3 ± 1.6 yrs). Ten
regularly menstruating women (mean age 28.9 ± 1.4 yrs) served as controls. Estradiol
serum levels as well as lumbar spine bone mineral density were measured. All 11 patients
with primary amenorrhea showed osteopenia with a mean bone mineral density Z-score
of 71 ± 2% and mean estradiol levels of 30.6 ± 5.9 pg/ml. The secondary amenorrheic
patients were significantly demineralized with a mean Z-score of 82 ± 3%; 10 of them
had osteopenia. Their mean estradiol levels were 34.3 ± 2.9 pg/ml. The bone density
in the primary amenorrheic patients was significantly lower as compared with the secondary
amenorrheic women. In comparison, lumbar spine bone density in all control women was
normal with a mean Z-score of 104 ± 3%. In summary, 21 of the 27 patients had osteopenia,
higher than that reported in post-menopausal women. Since it is not proven whether
the bone mineral deficit of amenorrheic patients can ever be compensated, early diagnostic
steps and estrogen-progestogen replacement for the prevention of further bone loss
and subsequent fractures are recommended.
Key words
Osteopenia - Osteoporosis - Amenorrhea - Gonadal Dysgenesis - Bone Mineral Density
- Estrogens
