Role of oestrogen in the development of osteoporosis.

The evidence now strongly supports a central role for oestrogen in the maintenance of the normal female skeleton. Loss of endogenous oestrogen leads to a period of accelerated bone loss which can be prevented with appropriate oestrogen replacement. The route of administration is not important provided adequate dosages are prescribed. Oestrogens may exert their actions by a direct steroid receptor mechanism or via local and/or systemic factors such as cytokines, prostaglandins or calcitonin. As the requirement for osteoporosis prevention grows, it is essential that the extent of the involvement oestrogen has in skeletal homeostasis is fully recognized.