PREVENTION AND TREATMENT OF OSTEOPOROSIS - DOES THE FUTURE BELONG TO HORMONE REPLACEMENT THERAPY

Estrogen replacement therapy (ERT) after menopause prevents the develo pment of osteoporosis and reduces the risk of fracture. Other potentia l benefits are cardioprotection-probably related to the effects of est rogen on lipid profile and fibrinogen levels- and a delay in the onset of Alzheimer's disease and perhaps amelioration of the disease. ERT, however, increases the risk of endometriosis and endometrial cancer un less given with a progestin for at least 10 days per menstrual cycle. If also results in a small but real increase in breast cancer. Alendro nate, a bisphosphonate, is the first serious competitor of conjugated equine estrogen for the treatment of osteoporosis. Nearing FDA approva l are so-called designer estrogens (e.g., raloxifene), which may selec tively prevent osteoporosis with little or no effects on endometrial a nd breast tissue.