PRESENT STATUS OF ESTROGEN TREATMENT FOR PREVENTION OF POSTMENOPAUSAL OSTEOPOROSIS

Abstract

Although both men and women tend to lose bane mass after age 40 the average rate of loss is thrice as great in women with average reduction in the womans skeletal mass amounting to 30% by age 70. Postmenopausal osteoporosis occurs in about 25% of postmenopausal women usuallyby age 60. It is characterized by evidence of decalcification of bone tissue; decrease in stature; and kyphosis. Severe joint pains eventually ensue along with infirmities associated with multiple fractures. The interplay between the individuals osteoblastic (deposition of osteoid) and osteoclastic (resorptive) activaities in the bone modelling processes is influenced by many factors such as estrogens; androgens; thyroid and growth hormones all of which increase bone mass and parathyroid hormone and glucocorticoids which decrease bone mass. Estrogens affect the calcification process by stimulating the absorption of calcium and phosphorus; by stimulating the activity of osteoblasts; and by inhibiting the activity of osteoclasts. Diagnosis of osteoporosis must be established on the basis of clinical examination and on laboratory and radiologic findings. Some of the methods used to measure bone mass include radiographic densiometry; morphometry; x-ray spectrophotometry; and total body neutron activation analysis. Estrogen replacement therapy has been found to protect against postmenopausal bone loss. The carcinogenic potential of such therapy is yet to be resolved. As osteoporosis is a serious public health concern large-scale prospective studies should be done to determine the value of estrogen replacement therapy in preventing age-related fracture incidences as well as risk factors associated with such long-term treatment.