New forms of estrogenotherapy in postmenopausal osteoporosis

: Although estrogens, are not any more the first choice therapy for osteoporosis, the are still important and promising treatment option for women after menopause. In randomized clinical trials it was shown, that they have negative influence on risk of development of particular diseases, but even though they are very efficient remedy for symptoms of climacteric syndrome and act positively on quality of life and longevity. Side effects are highly dependent on dose and route of administration and that is why the new hormonal treatment modalities are being developed. It seems, that non-oral (transdermal, nasal, sublingual or vaginal) administration of estrogens preparations has better safety profile and at least as good influence on bones, as oral estrogens. What is more, low or ultralow doses of estrogens is beneficial for skeletal system, even if their effectiveness is dose-dependent. Also polytherapy with hormonal preparations of osteoporosis is under investigation. Combinations of estrogens with parathormone and estrogens with bisphosphonates may be used in treatment-resistant osteoporosis and in individuals with severe loss of bone mass. Anyway, new, well designed clinical trials are still required, which will asses different indications for substances with estrogens activity.