Role of estrogens in the management of postmenopausal bone loss

Research output: Contribution to journalReview article

46 Citations (Scopus)

Abstract

It is well known that estrogen deficiency is the major determinant of bone loss in postmenopausal women. Estrogen is important to the bone remodeling process through direct and indirect actions on bone cells. The largest clinical experience exists with estrogen therapy, demonstrating its successful prevention of osteoporosis as well as its positive influence on oral bone health, vasomotor and urogenital symptoms, and cardiovascular risk factors, which may not occur with other nonestrogen-based treatments. Compliance with HRT, however, is typically poor because of the potential side effects and possible increased risk of breast or endometrial cancer. Nevertheless, there is now evidence that lower doses of estrogens in elderly women may prevent bone loss while minimizing the side effects seen with higher doses of estrogen. Additionally, when adequate calcium, vitamin D, and exercise are used in combination with estrogen-based treatments, more positive increases occur in bone density. The benefits and risks of HRT must be assessed on a case-by-case basis, and the decision to use HRT is a matter for each patient in consultation with her physician. Estrogen-based therapy remains the treatment of choice for the prevention of osteoporosis in most postmenopausal women, and there may be a role for estrogen to play in the prevention of corticosteroid osteoporosis. Combination therapies using estrogen should probably be reserved for patients who continue to fracture on single therapy or should be used in patients who present initially with severe osteoporosis.

Original languageEnglish
Pages (from-to)143-162
Number of pages20
JournalRheumatic Disease Clinics of North America
Volume27
Issue number1
StatePublished - 2001

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Postmenopausal Osteoporosis
Estrogens
Osteoporosis
Bone and Bones
Therapeutics
Bone Remodeling
Oral Health
Endometrial Neoplasms
Vitamin D
Bone Density
Adrenal Cortex Hormones
Referral and Consultation
Exercise
Breast Neoplasms
Calcium
Physicians

All Science Journal Classification (ASJC) codes

  • Rheumatology

Cite this

Role of estrogens in the management of postmenopausal bone loss. / Gallagher, John Christopher G.

In: Rheumatic Disease Clinics of North America, Vol. 27, No. 1, 2001, p. 143-162.

Research output: Contribution to journalReview article

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