Menopause and PMS Clinic: Osteoporosis
Post-menopausal women have a substantial loss of collagen from the skin and the bone matrix which can be replaced with oestrogen therapy (Fig. 2). This has an obvious cosmetic and health effect upon the skin and will also increase the bone density in post-menopausal women. One in three women have a lifetime osteoporotic factor of the distal radius, proximal femur or the vertebral bodies of the spine. There is no doubt that the majority of these fractures can be prevented by simple measure such as HRT and that the effect is dose-dependant (Fig 3). Oestrogen therapy would also substantially increase the bone density of women with osteoporosis or who have had osteoporotic fractures. It is important to attempt oestrogen therapy as first-line therapy in combination with calcium and vitamin D and failing that it may be necessary to use bisphosphonates or the newer SERMs.