When and how to use estrogen therapy in women over 60.

The most significant indications for estrogen therapy in women over 60 are symptoms related to the vagina, bladder, and bones. But before starting therapy, make certain these symptoms are directly related to estrogen deprivation, and not to the aging process. In patients on long-term therapy, use the lowest dose of estrogen plus progestogen that will alleviate the symptoms in the shortest period of time. Patients should be carefully monitored to reduce the risk of endometrial carcinoma.