Menopausal symptoms are noted as estrogen deficiency affects target ti
ssues during the climacteric and after menopause. With estrogen replac
ement therapy (ERT), clinical signs, such as vasomotor symptoms and ge
nitourinary atrophy, abate. Estrogen replacement therapy protects agai
nst the development of osteoporosis and is used in its treatment. In a
ddition, ERT has a positive effect on serum lipids and appears to be p
rotective against coronary heart disease. More than 75% of all women e
xperience troublesome vasomotor symptoms during the climacteric years,
and osteoporosis is a major cause of morbidity and mortality in postm
enopausal women. In the United States, the current annual cost of trea
ting patients with osteoporosis is $10 billion dollars. With the aging
of the baby boom generation, it is estimated that osteoporosis-associ
ated costs may double in the next 30 years if interventions are not un
dertaken to reduce the incidence of osteoporosis. It is therefore impo
rtant for pharmacists and other health care practitioners to educate w
omen about ERT after menopause to reduce the risks of vasomotor sympto
ms, osteoporosis, and other problems. The incidence, etiology, symptom
s, and therapeutic measures used to reduce vasomotor symptoms are disc
ussed, and updates on pathophysiology, risk factors, prevention, and t
reatment of osteoporosis, with an emphasis on ERT, are reviewed.