ESTROGEN FOR THE PREVENTION AND TREATMENT OF OSTEOPOROSIS - INTERVENTION IN THE OLDER WOMAN

Osteoporosis, a clinical disorder that may lead to significant functio nal decline and decreased quality of life, affects many women over the age of 70. long-term experience with estrogen therapy has accumulated ; however, traditionally its use has been reserved for younger postmen opausal women. When one considers the demographics of the aging female population, the age associated increase in fracture risk, along with other risk factors for osteoporosis, the argument for intervention in the older postmenopausal woman is a convincing one. The most significa nt impact on the negative outcomes of this disorder can only be made b y identifying and treating women at risk before the onset of osteoporo tic fracture. Indications, risks, and benefits of estrogen therapy in the older postmenopausal woman are discussed, with practical guideline s for administration of various regimens of hormone replacement therap y and hints for maintaining compliance. The important role of the phys ician as a source of knowledge and as a liaison in the decision-making process of the individual patient is also emphasized.