ESTROGEN THERAPY FOR OSTEOPOROSIS - EVEN IN THE ELDERLY

There is uniform agreement that estrogen is beneficial to the skeleton, especially in perimenopausal women. Is it effective in late postmenopausal women who already have osteoporosis? Results from younger women are not necessarily applicable to older women, because the perimenopausal phase of rapid bone loss lasts only several years. Recent clinical trials in women with postmenopausal sis have shown that the bone density in estrogen-treated women increases by about 5%, compared with relatively stable values for placebo groups. Bone biopsy and biochemical data have shown that estrogen decreases bone resorption but does not enhance bone formation. Antiresorptive agents are able to produce a net increase of, at most, 10% in bone density. Unlike transdermal estrogens, oral cause greater increases in high-density lipoproteins (HDL), making the primary indication for the transdermal form one of compliance, which is an important aspect of care. Estrogen should be as a therapy for postmenopausal women who already have osteoporosis.