[Which is the better choice, estrogen or SERMs in postmenopausal women?].
Hormone replacement therapy (HRT) increases the bone mineral density (BMD) and reduces the risk of vertebral and hip fractures in postmenopausal women. But, long term HRT slightly increases the risk of breast cancer. Raloxifene is a selective estrogen receptor modulator that has estrogen agonist effects in the skeleton and cardiovascular system and estrogen antagonist effects in the uterus and breast. Raloxifene effectively prevents bone loss and significantly, increases lumbar spine, hip, and total body bone mineral density, raloxifene reduces the risk of vertebral fracture. Raloxifene treatment leads to no increase in vaginal bleeding or mastaigia and to greater than 70% reduction in risk for invasive breast cancer. But raloxifene increases the hot flashes in postmenopausal women. In conclusion, HRT is optimal therapy for prevention and treatment of osteoporosis in postmenopausal women with menopausal symptoms, raloxifene is optimal therapy for prevention and treatment of osteoporosis in postmenopausal women without menopausal symptoms.
Shintani
Masafumi
M
Department of Obstetrics and Gynecology, Nara Prefectural Mimuro Hospital.
D001943:Breast Neoplasms / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control; D019584:Hot Flashes / Q000139:chemically induced; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000150:complications / Q000517:prevention & control*; D020849:Raloxifene Hydrochloride / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects / Q000627:therapeutic use*; D016103:Spinal Fractures / Q000209:etiology / Q000517:prevention & control; D014592:Uterine Hemorrhage / Q000139:chemically induced
D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride