Endocrine Abstracts

Oestrogen replacement therapy remains one of the two licensed indications for the use of HRT. The rationale is sound. Oestrogen is from the time of puberty a major regulator of the resorption/formation balance and of the rate of recruitment of BMUs. Natural or surgical withdrawal of oestrogen results in acceleration of turnover, bone loss and potential osteoporosis. Similarly, in the postmenopause, restoration of oestrogen to premenopausal levels restrains turnover, inhibits resorption and prevents osteoporosis and fracture. A mass of in-vitro and observational findings is now complemented by RCTs data (most recently from the large WHI study) which reported an RR point estimate of 0.75 for all fractures and 0.66 for reduction in hip fractures in oestrogen treated women. HRT should be considered for all oestrogen-deficient women with, or at risk of, osteoporosis unless contraindicated.