Effects of hormone replacement therapy on connective tissue: why is this important?

Oestrogen deprivation has a negative effect on connective tissue and its turnover, although it can be difficult to distinguish these changes from those related to age. Such an effect can be prevented to some extent, and in some cases reversed, with oestrogen therapy. This has been shown to happen in the skin dermis, bone matrix, carotid artery media and intervertebral discs. This effect is also likely to extend to the extracellular non-collagenous matrix in all these systems, as oestrogen has profound effects on connective tissue turnover, regardless of the site. This has implications not only in maintaining the structure and aesthetic appearance of tissue, but also its strength and stiffness, and the functioning of neighbouring and surrounding organs. Large-scale clinical trials are necessary to help make informed recommendations regarding postmenopausal oestrogen use and its role in connective tissue turnover.