The role of hormonal therapy in osteoporosis

In developed societies, the post-menopausal period covers approximately one third of a woman's life. The deficit of oestrogens observed during the post-menopausal period significantly affects the course of many metabolic processes, causing a number of diseases and in consequence diminishing quality of life. Among others, bones belong to oestrogen-dependent tissues. The deficit of the protective influence of oestrogens compromises the dynamic balance of the bone transformation process towards resorption, thus reducing bone mass and quality, while increasing the risk of low-energy fractures. In recent years, differing views on the application of oestrogen/gestagen therapy have reached the level of controversy. The results of numerous clinical studies are far from unequivocal, with the whole subject one of heated debate. It has been confirmed that hormonal therapy prevents bone quality deterioration, while opening a protective umbrella around the bone, reducing the risk of osteoporotic fractures. A rational approach to weighing possible advantages against possible risks and a thorough evaluation of a patient's health condition allows for optimal therapy selection. (Pol J Endocrinol 2011; 62 (1): 61-64)