Author Affiliation: Department of Medical Education, Providence Health System and Oregon Osteoporosis Center, Portland, Ore.
Nearly 60 years ago, Fuller Albright originally recognized postmenopausal
osteoporosis in older women who presented with height loss, kyphosis, and
back pain as a result of vertebral fractures.1
He astutely surmised that the waning of estrogen levels after menopause resulted
in loss of bone tissue and increased skeletal fragility and predicted that
estrogen therapy would prevent fractures. The relationship between cessation
of ovarian function and loss of bone mass is now well established. An interval
of relatively rapid bone loss occurs in the years immediately following menopause,
and bone loss continues and even accelerates again in the very elderly. Estrogen
therapy preserves bone mineral density (BMD) in both younger and older postmenopausal
women.2 However, to date, no large randomized
clinical trials have evaluated the antifracture efficacy of estrogen.
McClung MR. Therapy for Fracture Prevention. JAMA. 1999;282(7):687-689. doi:10.1001/jama.282.7.687