To the Editor.—
I have read the question "Osteoporosis Prophylaxis in a Postmastectomy Patient?" and the two answers in the QUESTIONS AND ANSWERS section (1982;248:1108) and would like to draw attention to the possibility of progestogen prophylaxis of osteoporosis. If estrogens are contraindicated, progestogens alone may prove helpful and should be prescribed for such patients. Norethindrone, 5 mg/day, is recommended by Nordin et al,1 since it has been demonstrated that 5 mg of norethindrone is effective in reducing calcium excretion in the urine.2 Norethindrone or norethindrone acetate has been found useful as endocrine treatment in patients with breast cancer and can, therefore, be prescribed for osteoporosis prophylaxis if considered necessary.
Nadjafi C. Progestin Prophylaxis of Osteoporosis. JAMA. 1983;249(13):1710. doi:10.1001/jama.1983.03330370024020