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
20 - Hormone replacement therapy
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
The effects of hormone replacement therapy (HRT) on bone cannot be discussed in isolation, and the risks and benefits of therapy must be addressed as they relate to each individual. Hormone replacement therapy has been shown to have a positive impact on bone mineral density (BMD) in all areas of the skeleton that have been studied and has been shown to reduce the risk of osteoporotic fractures. Positive effects of estrogen on the cardiovascular system have also been reported; however, more recently there is evidence to the contrary. The association of unopposed estrogen therapy to uterine cancer is established and it is felt that the addition of a progestational agent reduces that risk. The potential association of estrogen therapy with increased risk of breast cancer remains an area of controversy. However, it is likely that there is a slight increase in risk. HRT unequivocally aids with menopausal symptoms and is the reason most women consider it. Hot flashes, flushes, and urogenital symptoms may be improved with HRT. Recent suggestions that associate improved memory with HRT are encouraging, but require further study. As is evident, the amount of information that needs to be assimilated by both patient and physician is formidable, making the decision to commence HRT a difficult one. This chapter is an attempt to summarize a very complex and changing area.
- Type
- Chapter
- Information
- The Osteoporosis Primer , pp. 277 - 290Publisher: Cambridge University PressPrint publication year: 2000