Post-menopausal osteoporosis and estrogens. Who should be treated and why.

Estrogen deficiency after menopause results in loss of skeletal calcium and increased risk of bone fractures. Administration to postmenopausal women of a daily dose of 0.625 mg of conjugated equine estrogen, 1 mg estradiol-17 beta, or 0.15 mg ethinyl estradiol prevents these changes. The safety of long-term estrogen administration has not been established by large-scale controlled studies. Therefore, hormone treatment should be reserved for patients with symptoms of estrogen deficiency or for subsets of persons at increased risk of osteoporotic bone fractures. These include fair-skinned or lightweight persons, smokers, heavy drinkers, persons on prolonged corticosteroid therapy, and those with early menopause or rheumatoid arthritis.