Estrogen therapy for postmenopausal symptoms and prevention of osteoporosis.

Menopausal symptoms are noted as estrogen deficiency affects target tissues during the climacteric and after menopause. With estrogen replacement therapy (ERT), clinical signs, such as vasomotor symptoms and genitourinary atrophy, abate. Estrogen replacement therapy protects against the development of osteoporosis and is used in its treatment. In addition, ERT has a positive effect on serum lipids and appears to be protective against coronary heart disease. More than 75% of all women experience troublesome vasomotor symptoms during the climacteric years, and osteoporosis is a major cause of morbidity and mortality in postmenopausal women. In the United States, the current annual cost of treating patients with osteoporosis is $10 billion dollars. With the aging of the baby boom generation, it is estimated that osteoporosis-associated costs may double in the next 30 years if interventions are not undertaken to reduce the incidence of osteoporosis. It is therefore important for pharmacists and other health care practitioners to educate women about ERT after menopause to reduce the risks of vasomotor symptoms, osteoporosis, and other problems. The incidence, etiology, symptoms, and therapeutic measures used to reduce vasomotor symptoms are discussed, and updates on pathophysiology, risk factors, prevention, and treatment of osteoporosis, with an emphasis on ERT, are reviewed.