Personal perspective on low-dosage estrogen therapy for postmenopausal women.
OBJECTIVE
As evidenced by results from recent clinical trials and epidemiological studies that have examined the physiological and clinical effects of low levels of estradiol, it is now time to replace the widely held belief that less than the standard dosage of estrogen is without benefit.


METHODS
Review of literature and personal experience.


RESULTS
Studies indicate that low-dosage estrogen can relieve vasomotor symptoms, can prevent bone loss, and may reduce the risk of coronary heart disease. However, to achieve these health benefits, long-term estrogen use is required. Women who use low dosages of estrogens are less likely to have unacceptable side effects, such as irregular bleeding, heavy bleeding, or breast tenderness. Thus, long-term continuance of hormone replacement therapy (HRT) may be improved if lower dosages are given, particularly if the HRT regimen is tailored to the needs of the patient.


CONCLUSIONS
Although standard-dosage estrogen remains the "gold standard" for HRT, having a low dosage as an alternative regimen can be useful. Attention of clinical researchers should focus on the effects of low-dosage estrogen on osteoporotic fractures and other health outcomes.
Ettinger
B
B
Division of Research, Kaiser Permanente Medical Care Program, Oakland, CA 94611, USA.
D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015914:Estrogen Replacement Therapy / Q000379:methods*; D004967:Estrogens / Q000008:administration & dosage*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D017698:Postmenopause / Q000187:drug effects; D011379:Prognosis; D016896:Treatment Outcome
D004967:Estrogens