Lello, S; Capozzi, A; Scambia, G
Early post-menopause is a critical period for bone metabolism.It is well known hormonal status strongly influences skeletal health in association with other clinical risk factors. Different hormonal replacement therapies used to treat vasomotor symptoms, including classical HRT (Hormonal Replacement Therapy consisting of estrogens plus progestin for women with intact uteri), ERT (Estrogen Replacement Therapy without progesteron for women without uteri) or Tibolone, can precociously protect bone from loss of Bone Mineral Density (BMD), bone quality and vertebral and non vertebral fragility fracture risk. The Tissue-Selective Estrogen Complex (TSEC), a new pharmacological compound composed by conjugated estrogens (CE), 0.45 mg/day associated with 20 mg/day bazedoxifene (BZA) recently approved for treatment of menopausal symptoms, resulted an effective and safe therapy even in order to preserve bone. However, there are still few data about the possible effects of TSEC assumption on bone quality parameters other than serum bone turnover markers. Trabecular Bone Score (TBS) is a new direct measure of bone quality obtained from dual-energy X-ray absorptiometry (DXA) analysis. It offers an innovative parameter to add to BMD assessment a reproducible numerical evaluation of bone integrity on the basis of standard DXA. The combination ofboth methods could give more information about bone health analyzing skeletal status from different aspects and help clinicians to better document the impact of pharmacological therapies. Here, we describe two clinical cases regarding two young postmenopausal women treated with TSEC and their short-term response to therapy concerning BMD and TBS score.