Prevention and treatment of osteoporosis: does the future belong to hormone replacement therapy?
Estrogen replacement therapy (ERT) after menopause prevents the development of osteoporosis and reduces the risk of fracture. Other potential benefits are cardioprotection--probably related to the effects of estrogen on lipid profile and fibrinogen levels--and a delay in the onset of Alzheimer's disease and perhaps amelioration of the disease. ERT, however, increases the risk of endometriosis and endometrial cancer unless given with a progestin for at least 10 days per menstrual cycle. It also results in a small but real increase in breast cancer. Alendronate, a bisphosphonate, is the first serious competitor of conjugated equine estrogen for the treatment of osteoporosis. Nearing FDA approval are so-called designer estrogens (e.g., raloxifene), which may selectively prevent osteoporosis with little or no effects on endometrial and breast tissue.
Gibaldi
M
M
Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle 98195, USA.
D019386:Alendronate / Q000627:therapeutic use*; D000544:Alzheimer Disease / Q000517:prevention & control; D002116:Calcitonin / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D003327:Coronary Disease / Q000517:prevention & control; D004164:Diphosphonates / Q000627:therapeutic use; D016889:Endometrial Neoplasms / Q000139:chemically induced; D004715:Endometriosis / Q000139:chemically induced; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use; D005544:Forecasting; D006801:Humans; D010024:Osteoporosis / Q000188:drug therapy* / Q000517:prevention & control*; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000139:chemically induced; D012969:Sodium Fluoride / Q000627:therapeutic use; D013927:Thrombosis / Q000139:chemically induced; D014807:Vitamin D / Q000627:therapeutic use
D004164:Diphosphonates; D005460:Fluorides, Topical; D014807:Vitamin D; D012969:Sodium Fluoride; D002116:Calcitonin; D002118:Calcium; D019386:Alendronate