HRT and Osteoporosis is a response to the increasing awareness among both the medical profession and the general public that ovarian failure is an important cause of osteoporosis and that much of the bone loss after the menopause can be prevented by oestrogen treatment. There is now an urgent need on the part of women, their doctors and those responsible for public health policy for practical guidance on such questions as the safety and acceptability of long-term treatment with sex hormones, the economic costs and benefits of such treatment, and the role of specialists and GPs in promoting and monitoring hormone replacement therapy. All these issues and more are considered here. The book comprehensively reviews current knowledge of the subject and gives recommendations for clinical practice and future research.
Inhaltsverzeichnis
Section I: Pathophysiology of the Menopause.- 1 Biology of the Menopause.- 2 The Biology of Bone.- 3 Symptoms and Metabolic Sequelae of the Menopause.- 4 Psychological Effects of the Menopause.- 5 Oestrogen Deficiency and Connective Tissues.- 6 Oestrogen Deficiency and the Bladder.- Section II: Pathophysiology of Osteoporosis.- 7 Epidemiology of Osteoporosis.- 8 Implications of Osteoporotic Fractures in the Elderly.- 9 Structure of Osteoporotic Bone.- 10 Endocrinology and Osteoporosis.- 11 The Measurement of Bone Density.- 12 Screening Techniques in the Evaluation of Osteoporosis.- 13 The Patient s View of Osteoporosis.- Section III: Risks and Benefits of HRT.- 14 Hormone Replacement Therapy and the Risk of Cancer in the Breast and Reproductive Organs: A Review of Epidemiological Data.- 15 Oestrogens and Cancer.- 16 Progestogens: Symptomatic and Metabolic Side Effects.- 17 Oestrogen Replacement Therapy and Cardiovascular Disease.- 18 Oestrogens and Thrombosis.- Section IV: Therapeutic Potential.- 19 Population Screening and the Prevention of Osteoporosis.- 20 Long-term Follow-up of Women on HRT.- 21 Effects of Oral, Percutaneous and Transdermal Oestrogens on Postmenopausal Bone.- 22 Reversal of Bone Loss with Percutaneous Oestrogens.- 23 Prevention and Treatment of Osteoporosis.- 24 Lifestyle, Exercise and Osteoporosis.- Section V: HRT and the Community.- 25 Premenopausal Hormone Therapy.- 26 Hormone Replacement Therapy in the Menopause: Risks, Benefits and Costs.- 27 Should HRT be Recommended in the Community?.- Conclusions and Recommendations.
