Hormone replacement therapy and fractures in older adults

Estrogen deficiency in women is associated with accelerated bone loss, and estrogen replacement therapy has been proven to be effective in preventing osteoporosis and fractures in postmenopausal women. The introduction of sel ective estrogen receptor modulators that have an estrogen-like effect on th e skeleton but have a different pattern of effects on other tissues may hav e an important role in the management of osteoporosis in women in the near future. In men, androgen deficiency has been shown to be associated with os teoporosis, Although androgen replacement in hypogonadal men may decrease b one resorption and increase bone mass, long-term placebo-controlled trials are needed to better define the benefits and risks of such therapy before i t can be recommended. Sex hormone deficiency is linked to the development o f osteoporosis in both women and men. In women, hormonal replacement by est rogen or the newly developed selective estrogen receptor modulators may pre vent the development of osteoporosis and its related fractures. In men, the re is early evidence that testosterone replacement therapy may enhance bone mass in hypogonadal men.