Estrogen therapy not long ago has ...

Estrogen therapy not long ago has been shown to increase the risk of breast cancer, heart disease, affliction and deep venous thrombosis, unless it also decreases the risk of hip fracture. While conventional dosages of estrogen therapy reduc bone los and bone turnover, lower dosages of estrogen appear to have an equally beneficial purport without adverse events when taken with adequate dosages of calcium and vitamin D Prestwood and colleagues designed a subject of attention to determine the long-term general intents of 0.25 mg a day of 17-beta-estradiol treatment forward bone, as well as to establish the safety profile of this dosage.

Participants were healthy community-dwelling women with no late estrogen or calcitonin use and no past bisphosphonate use. The women were randomized to receive 17-beta-estradiol or placebo. All women who had not had a hysterectomy also received 100 mg a day of micronized progesterone for sum of two units weeks every six months. All participants also received 1300 mg a day of elemental calcium and 1000 IU a day of vitamin D The primary consequence was bone mineral density (BMD) of the hip, measured at baseline and annually for three years. Spine, wrist, and total-body BMD also were evaluated. Bone turnover was evaluated by dint of measuring various markers and sex hormones. Endometrial thickness was evaluated at baseline, and all women were asked to sustain endometrial biopsies at three years, as well as annual mammography. Adverse weights were otherwise assessed by questionnaire.

Of the 167 women included in the thought 31 (37 percent) discontinued participation in the placebo form into groups and 24 (29 percent) discontinued participation in the 17-beta-estradiol arrange Low-dose estrogen significantly increased bone density at all BMD sites compared with placebo. Women who received progesterone had the same changes as those who did not. The estradiol dispose had significantly lower markers of bone turnover than the placebo cluster Endometrial thickness increased slightly in the two groups over the three years, with a significant difference set up only at two years. There was no statistically significant difference in endometrial biopsy categories between the brace groups. There were no significant differences in adverse symptoms or the total number of abnormal mammogram eventuates in the two groups.

This application of mind is the first to demonstrate that ultra-low-dose estrogen can increase BMD throughout the long term. A daily dose of 025 mg of 17-beta-estradiol increased BMD at the hip, spine, and wrist, and decreased markers of bone turnover in a three-year period. The side-effect profile was similar to that of placebo. Higher estradiol plains may not provide additional benefit to bone while increasing risk of adverse incidents The authors call for longer studies to establish the efficacy of cheap dosages of estrogen in preventing fractures.

Prestwood KM et al. Ultra low-dose micronized 17bestradiol and bone density and bone metabolism in older women JAMA August 27 2003;290:1042-8

COPYRIGHT 2004 American Academy of Family Physicians

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