Roux C
Bone Disease Evaluaiton Center, Cochin Teaching Hospital, Paris, France.
Rev Rhum Engl Ed. 1997 Jun;64(6):402-9.
Replacement estrogen therapy is of proven efficacy for the prevention and treatment of postmenopausal bone loss. Oral and transdermal 17 beta estradiol have provided similar benefits in clinical studies. The lowest effective doses are 0.625 mg per day for conjugated estrogens, 2 mg per day for oral 17 beta estradiol, 1.5 micrograms per day for 17 beta estradiol gel, and 50-microgram 17 beta estradiol patch per day. Bone mineral density should be monitored if lower doses are used. Several epidemiologic studies found that a decrease in the incidence of osteoporotic fractures was achieved only when the duration of estrogen replacement therapy exceeded seven years. It follows that replacement therapy should be started at cessation of menses, if possible. However delayed replacement therapy (i.e., at 65 years of age) is unquestionably effective.
替代雌激素疗法在预防和治疗绝经后骨质流失方面已被证明有效。在临床研究中，口服和经皮给予的17β-雌二醇具有相似的益处。最低有效剂量为：结合雌激素每日0.625毫克，口服17β-雌二醇每日2毫克，17β-雌二醇凝胶每日1.5微克，以及17β-雌二醇贴片每日50微克。如果使用较低剂量，应监测骨矿物质密度。多项流行病学研究发现，只有当雌激素替代疗法的持续时间超过七年时，骨质疏松性骨折的发生率才会降低。因此，如果可能的话，替代疗法应在月经停止时开始。然而，延迟替代疗法（即65岁时）无疑是有效的。
