Bone mineral density decrease prevention

Although estrogens increase bone mineral density and decrease fractures, they are no longer recommended for osteoporosis prevention because of toxicity concerns. When used to treat menopausal symptoms, they will have a positive bone effect. 

Tibolone (Livial) is widely used in treatment of vasomotor symptoms and prevention of osteoporosis. The parent compound itself is devoid of activity, but it is metabolized in a tissue-selective manner to three metabolites that have predominantly estrogenic, progestogenic, and androgenic activities. The drug appears to increase bone mineral density and decrease vasomotor symptoms without stimulating the endometrium, but its effects on fractures, breast cancer, and long-term outcomes remain to be established. 

Osteoporosis is a skeletal condition characterized by decreased bone mineral density (BMD) (mass/volume unit) that leads to an increased risk of fractures (Beikler and Flemmig, 2003). A number of studies have identified that osteoporosis occurs much more frequently in females compared to males (Cadarette et al, 2000 Hannan et ah, 2000 Schuit et ah, 2004). There are a number of reasons for the high prevalence of osteoporosis in females. First, at skeletal maturity, males have 30-50% bone mass compared to females (Christiansen, 1993 Nieves et ah, 2005). Second, although decreased BMD occurs in both males and females with age, the decreased of BMD is substantially greater in females after menopause (Kanis et ah, 1997 Riggs et ah, 2004, 2008). Therefore, it is very important to help postmenopausal females to prevent them from progressing to osteoporosis. 

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