Osteoporosis and Estrogen

Osteoporosis is a disease of the skeletal system that causes the bones to become weak and susceptible to fracture. The most common sites for these types of fractures are in the hip, spine and wrist, though they may occur anywhere.

There has been no single cause identified in osteoporosis however it is characterized by a loss of bone density. There is no cure for osteoporosis but there are several treatment methods available and it is largely preventable in most people.

Bone Mass

Overwhelming evidence has established a major role for estrogen replacement following menopause as a means to conserve bone mass. Moreover, estrogen replacement protects against painful bone fractures that result from osteoporosis. The relationship between estrogen and bone health has been known for a long time.

The use of estrogen as a means of preventing bone loss however continues to be the subject of much discussion and debate. Bone is constantly being broken down and built back up. This process is called bone remodeling. The breaking down of bone is called resorption.

Estrogen helps to control the balance between the breakdown and renewal of bone tissue. With age, as the level of estrogen falls the breakdown of bone speeds up while the renewal is slowed leading to a larger amount of bone mass being lost.

Osteoporosis is a common bone disease in postmenopausal women; it is believed that this is directly related to the sudden and dramatic loss of estrogen. In addition to a lower risk of osteoporosis and fractured bones, other benefits of estrogen replacement in the postmenopausal patient include lower cholesterol, decreased risk of colon cancer, and fewer postmenopausal symptoms.

Safety

Recent studies question the safety of estrogen use over many years. Women who take estrogen have an increased risk for developing certain cancers. Standard practice requires the administration of progesterone hormones along with the estrogens to women who have an intact uterus.

This progesterone can be given in several forms, and it can be administered continuously, or else periodically during the month. The most common form of progesterone prescribed will not interfere with the beneficial skeletal effects of estrogen, however has been shown to lessen the risks of taking estrogen alone in women who still have a uterus.

While long term estrogen use has shown some adverse effects, studies show that prolonged use helps to increase bone mass by at least 5% over two years. At least 5 years of estrogen therapy is recommended to protect against serious fractures, including those of the hip and spine. Estrogen can be taken orally or transdermally via a patch.

While estrogen, even if administered properly, can prevent further bone depletion, it does not replace bone that has already been lost. Before starting an estrogen regimen for the prevention of osteoporosis the benefits and risks should be thoroughly discussed and weighed with the help of a physician. In order to regain lost bone mass a healthy diet and exercise in combination with estrogen treatment prevention of osteoporosis or of fractures resulting may be ascertainable.