A new look at osteoporosis and estrogen replacement therapy

With very few exceptions, including those patients with breast cancers and positive estrogen receptors, patients with advanced endometrial carcinoma, and patient with recurrent thrombophlebitis, the vast majority of postmenopausal women are candidates for estrogen replacement therapy. A therapeutic regimen can consist of estrogen for the first 25 days of the month and the addition of a progestational agent from the 16th through the 25th day of the month in dosages of 0.625 mg of conjugated estrogen or 20 μg of ethinyl estradiol, and medroxyprogesterone acetate 10 mg. Endometrial sampling should be reserved for those individuals having withdrawal bleeding that is excessive or that occurs during the estrogen or early progesterone portion of the treatment cycle. For patients without a uterus, a daily estrogen replacement regimen on a continuous basis, or one interrupted only for short three-to-five-day periods to afford diuresis, is recommended.