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Bone Density Maintained By Continuous Estrogen Use In Elderly Women

WESTPORT, Feb 19 (Reuters) - Three San Diego clinicians have confirmed the hypothesis that "...current estrogen use [is] better than past use for the maintenance of bone density," and suggest that "...current therapy begun years after menopause might be as beneficial as continuous treatment begun at the time of menopause."

In today's issue of The Journal of the American Medical Association, Dr. Elizabeth L. Barrett-Connor and colleagues at UC San Diego in La Jolla, describe their study of 740 women. The San Diego team evaluated bone mineral density at four sites and correlated bone mineral density with postmenopausal estrogen use.

They categorized five groups of estrogen users: never users, past users who started at menopause, past users who started after 60 years-of-age, current users who started after menopause, and current users who started after 60 year-of-age.
Dr. Barrett-Connor reports that "...[c]urrent users of estrogen had the highest [bone mineral density] levels at all four sites, independent of the duration of use." She adds "Among current users, there was no statistically significant difference in bone mineral density between those who started estrogen at menopause and those who started after age 60 years."

The researchers also found that "...[a]mong past estrogen users, women who started estrogen after age 60 years had higher mean [bone mineral density] levels than those who started earlier, although the years of use were fewer." This result together with those of others suggest to the authors that "...estrogen therapy taken only at the time of menopause preserves bone during use, but it may not preserve bone density later in life or protect against osteoporotic fracture."

"If late continuous use is equivalent to early-onset continuous use, estrogen therapy could be initiated at older ages when most osteoporotic fractures occur, reducing the cost and possible risks of long-term estrogen therapy," Dr. Barrett-Connor concluded. JAMA 1997;277:543-547.


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