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©2013 UpToDate ® Print Email Effects of different therapies on bone mineral density in postmenopausal osteoporosis Mean percentage change (±SE) from baseline in bone mineral density at the lumbar spine, total hip, total body, and one-third distal forearm during four years of therapy in healthy postmenopausal women. Red lines represent treatment with estradiol-norethisterone acetate (E-N); blue lines represent estrogen-medroxyprogesterone acetate (E-MPA); green lines represent alendronate, 5 mg/day (Al-5); orange lines represent alendronate, 2.5 mg/day (Al-2.5); and black dashed lines represent placebo. For graphical presentation, results from groups that received the same dose of alendronate during the first two years of the study were pooled. All of the therapies prevented bone loss, with E-N having the greatest effect at the spine and total body. Data from: Ravn P, Bidstrup M, Wasnich RD, et al. Alendronate and estrogen-progestin in the long-term prevention of bone loss: four-year results from the early postmenopausal intervention cohort study. A randomized, controlled trial. Ann Intern Med 1999; 131:935.