Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- Part IV Clinical aspects of osteoporosis
- 17 Biochemical markers of bone turnover
- 18 Radiologic assessment of osteoporosis
- 19 Bone mineral density measurements
- 20 Hormone replacement therapy
- 21 Selective estrogen receptor modulators
- 22 Bisphosphonate therapy of osteoporosis
- 23 The action of fluoride on bone
- 24 PTH peptides as anabolic agents in bone
- 25 Vitamin D and vitamin D analogs as therapeutic agents
- Index
21 - Selective estrogen receptor modulators
Published online by Cambridge University Press: 01 June 2011
- Frontmatter
- Contents
- List of contributors
- Preface
- Part 1 Molecular and cellular environment of bone
- Part II Determinants of peak bone mass
- Part III Pathophysiology of the aging skeleton
- Part IV Clinical aspects of osteoporosis
- 17 Biochemical markers of bone turnover
- 18 Radiologic assessment of osteoporosis
- 19 Bone mineral density measurements
- 20 Hormone replacement therapy
- 21 Selective estrogen receptor modulators
- 22 Bisphosphonate therapy of osteoporosis
- 23 The action of fluoride on bone
- 24 PTH peptides as anabolic agents in bone
- 25 Vitamin D and vitamin D analogs as therapeutic agents
- Index
Summary
Introduction
Estrogens are frequently prescribed to perimenopausal and postmenopausal women for control of menopausal symptoms such as hot flashes, vaginal dryness, and memory disturbances. More recently, estrogens have been recognized and used for long-term protection against chronic diseases related to estrogen deficiency, most notably osteoporosis and heart disease. Estrogens have diverse multisystemic effects (Ettinger, 1998) including those on the central nervous system and have, therefore, been implicated in maintaining normal cognitive function and possibly reducing the risk of Alzheimer's disease (Henderson, 1997). Estrogens have also been linked to a reduced risk of colorectal cancer. Use of estrogens is limited, however, due to stimulatory effects on both the uterus and the breast, as well as some troublesome side-effects. In the uterus, there may be an increase in the risk of uterine cancer even when progestins are given appropriately (Beresford et al., 1997). Furthermore, the body of epidemiologic data suggests an increase in the risk of breast cancer, at least after long-term (>5–10 years') use (Collaborative Group, 1997). The increased risk of deep venous thrombosis has also been recently described in epidemiologic studies. Side-effects such as breast tenderness and engorgement, vaginal bleeding with many hormone replacement regimens, and a perception that hormone use is associated with weight gain, headaches, and nausea are other symptoms which limit estrogen use.
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- Information
- The Osteoporosis Primer , pp. 291 - 303Publisher: Cambridge University PressPrint publication year: 2000
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