OSTEOPOROSIS PREVENTION WITH SEX-HORMONE REPLACEMENT THERAPY

It was suggested as long ago as 1941 that there might be a connection between the menopause and osteoporosis. Since then, abundant data have confirmed that hypothesis as well as showing that such osteoporosis m ay be prevented by estrogen supplementation (ERT-estrogen replacement therapy). In estrogen deficiency, increased bone resorption takes plac e in the process of bone remodeling, leading to bone loss. The bone lo ss occurs universally but to the greatest extent at sites rich in trab ecular bone. There are uncertainties concerning extent of bone loss at various sites at different ages, effect of ERT at varying sites and d ifferent ages, degree of fracture prevention, and relationship between duration of therapy and fracture risk. That optimal fracture risk is not being attained now on a population basis is due to apparently low acceptance of ERT by patients and lack of strenuous effort in that dir ection by physicians.