EUROPEAN AND NORTH-AMERICAN EXPERIENCE WITH HRT FOR THE PREVENTION OFOSTEOPOROSIS

Citation
Ef. Eriksen et al., EUROPEAN AND NORTH-AMERICAN EXPERIENCE WITH HRT FOR THE PREVENTION OFOSTEOPOROSIS, Bone, 19(5), 1996, pp. 179-183
Citations number
46
Categorie Soggetti
Endocrynology & Metabolism
Journal title
BoneACNP
ISSN journal
87563282
Volume
19
Issue
5
Year of publication
1996
Supplement
S
Pages
179 - 183
Database
ISI
SICI code
8756-3282(1996)19:5<179:EANEWH>2.0.ZU;2-E
Abstract
Hormone replacement therapy (HRT) has been the method of choice for th e prevention of postmenopausal osteoporosis since the early 1990s, Alt hough a number of routes of administration are now available, HRT is s till predominantly administered orally, In the United States, HRT form ulations traditionally comprise conjugated equine estrogens, In Europe , however, HRT preparations tend to be based on 17 beta-estradiol, a n atural human estrogen, Furthermore, distinct patterns of HRT use are a pparent based on the age of the woman receiving it, Current recommenda tions are that early postmenopausal women (in their early 50s) receive sequential combined estrogen/progestogen therapy with continued month ly bleeds, while in women who are at least 1 year postmenopausal, cont inuous combined HRT, which leads to endometrial atrophy and cessation of monthly bleeding, is preferred, Clinical experience to date clearly demonstrates that long-term HRT unequivocally increases bone mass and reduces the risk of fractures in postmenopausal women, with no signif icant differences between sequential and continuous combined prescribi ng regimens, Data demonstrating that antiestrogens such as tamoxifen m ay preserve bone mass have led to the initiation of large-scale trials to determine the potential clinical utility of such agents for the pr evention of osteoporosis in postmenopausal women, Nonhormonal therapeu tic approaches are now also available, most notably bisphosphonates an d vitamin D analogs, At present, however, traditional HRT remains the regimen of choice for the prevention of postmenopausal osteoporosis, g iven its additional beneficial effects on acute menopausal symptoms, a s well as on the cardiovascular system and brain. (C) 1996 by Elsevier Science Inc.