Estrogens, bone mass, and osteoporotic fracture

C ross-sectional data accumulated over many years have set the point at which bone loss begins in women at approximately the time of menopause.This temporal relationship lent credence to Albright's [l] hypothesis that the loss of ovarian function is causally related to osteoporotic fracture.However, until prospective studies were completed demonstrating that estrogen reduced the rate at which postmenopausal women lose bone mass, doubts remained about the role of estrogen deficiency in the pathogenesis of osteoporosis, particularly since the mechanism of action was obscure.During the last few years, considerable information has been accumulated about the effects of estrogen in preventing bone loss as well as treating the established syndrome [2].In addition, there are now sufficient data to allow a postulated mechanism of action to be proposed.This review examines some of the evidence.