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Dr Hustead's perceptive comments on the relative potencies of conjugated estrogen and ethinyl estradiol are appreciated. While previous reports had suggested that 25 to 50 μg of ethinyl estradiol was protective against osteoporosis,1 these dosages were arbitrarily chosen. Mandel et al2 recently reported that 10 μg of ethinyl estradiol is approximately equivalent to 1.25 mg of conjugated estrogens on the basis of both hepatic and nonhepatic measurements, suggesting that ethinyl estradiol is far more potent than previously believed. Bolton et al3 found that 20 μg of ethinyl estradiol is equivalent to 1.25 mg of conjugated estrogen in the suppression of luteinizing hormone. However, Rudel and Kincl4 concluded that conjugated estrogen at a dose of 1.25 mg daily is more potent than 20 μg of ethinyl estradiol when compared on the basis of endometrial proliferation, vaginal cytology, and cervical mucus ferning. Therefore, while 5 to
Maxson WS. Estrogen Dosage-Reply. JAMA. 1984;251(17):2210. doi:10.1001/jama.1984.03340410022021
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