Estrogen / Premarin

- See: Osteoporosis

- Discussion:
    - for most postmenopausal women with osteoporosis, estrogen therapy also should be instituted at a dose of 0.625 mg of conjugated estrogen per day or its equivalent;
    - administration of estrogen by transdermal patch is effective and may result in more stable plasma estrogen concentrations;
    - at menopause, bone turnover increases, w/ greater increase in bone resorption than in bone formation;
    - accelerated bone loss that results diminishes exponentially with time;
           - most bone is lost during the first 3 to 6 years after menopause, but some loss related to low estrogen levels may continue for up to 20 years;
    - if begun soon after menopause, estrogen therapy prevents early phase of bone loss and decreases the incidence of subsequent osteoporosis related fractures by about 50 percent;
    - in women with established osteoporosis, estrogen therapy is still effective;
         - there is a reduction in hip and wrist frx in women whose estrogen replacement was begun within a few years of menopause;
         - even when started as late as 6 years after menopause, estrogen replacement prevents further loss of bone mass but does not restore it to premenopausal levels;
    - there is no convincing evidence that estrogen benefits women over the age of 75 years;

- Dosing:
    - Estrogen Protocol for Osteoporosis:
         #1 (for women w/ a uterus w/o vaginal withdrawl bleeding - 60%)
             - Premarin 0.625 mg PO qd
             - Provera 2.5 mg PO qd
         #2 (for women w/ a uterus and w/ withdrawl bleeding - 40%)
             - Premarin 0.625 mg PO qd for 20 days.
             - Provera 10 mg PO qd 10 days.
         #3 (for women w/o a uterus)
             - Premarin 0.625 mg PO qd for 25 days.
             - then nothing for 5 days.

Effects of estrogen deficiency on the growth of tissue into porous titanium implants.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, August 13, 2012 2:00 pm