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Long-Term Estrogen Replacement Therapy Prevents Bone Loss and Fractures

BRUCE ETTINGER, M.D.; HARRY K. GENANT, M.D.; and CHRISTOPHER E. CANN, Ph.D.
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Grant support: in part by the Community Service Program of Kaiser Foundation Hospitals, and the protocol was approved by the Institutional Review Board. Also supported by grant AM 27926 from the National Institutes of Health, and by Ayerst Pharmaceuticals, Inc.

Presented in part at the Seventh Oceania Congress of Endocrinology, 22-26 August 1982, Tokyo, Japan.

▸Requests for reprints should be addressed to Bruce Ettinger, M.D.; Department of Medicine, Kaiser Permanente Medical Center, 2200 O'Farrell Street; San Francisco, CA 94115.


San Francisco, California


© 1985 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1985;102(3):319-324. doi:10.7326/0003-4819-102-3-319
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Although several case-control studies have shown an inverse association between postmenopausal estrogen use and fractures, quantitation of fracture incidence has been lacking. To quantify the degree to which estrogen replacement therapy prevents postmenopausal osteoporosis, a retrospective study was done comparing the occurrence of fractures in 245 long-term estrogen users and 245 case-matched controls, followed for an average of 17.6 years. Quantitative bone mineral assessments were obtained from 18 women using estrogen replacement therapy and their controls (average age, 73 years). Osteoporotic fracture incidence in estrogen users was 50% as great as in the controls (p < 0.01). Estrogen users showed significantly greater bone mineral: 54.2% greater spinal mineral (p < 0.0002), 19.4% greater forearm mineral (p < 0.0005), and 15.6% greater metacarpal cortical thickness (p < 0.005). Long-term estrogen replacement therapy confers significant protection against bone loss and fracture.

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