Kidney and Metabolic Bone Diseases Vol.17 No.2(6)

Theme Menopausal derangement in bone metabolism
Title Hormone replacement therapy (HRT) in postmenopausal women with osteoporosis
Publish Date 2004/04
Author Masafumi Shintani Department of Obstetrics and Gynecology, Nara Prefectural Mimuro Hospital
[ Summary ] Hormone replacement therapy prevents a decline in bone density in postmenopausal women and prevents the risk of osteoporotic fractures. However, long-term compliance with a standard dose of CEE 0.625 mg/day is lower for Japanese patients because of the incidence of vaginal bleeding and breast pain. The ratio of vaginal bleeding and breast pain were reduced with low dosage for HRT (CEE 0.31 mg/day), and compliance was higher than the seen with standard HRT dosage. In our patients, the changes in lumbar bone density were seen as increasing by approximately 5% in low dosage HRT at three years use in osteoporotic women, and the ratio of vertebral fractures significantly decreased. An observational study reported that HRT was protective for cardiovascular and cerebrovascular events. But in a recent WHI study, the risks of cardiovascular andcerebrovascular events were elevated. Bisphosphonate and raloxifene may need to made be available. Treatment for osteoporosis in postmenopausal women needs to be providation an elective basis, in consideration of the benefits and risks for individual patients.
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