Estrogen administration in a menopausal woman increases the
Correct Answer: Bone mass
Description: Ans. is c i.e Bone mass Before seeing any Reference for the Question let's rule out some options. Estrogen administration will exe a negative feedback on gonadotropin secretion and decreases Gonadotropin secretion rather than increasing it (Option 'a' ruled out). As I have already discussed in previous Question -Estrogen decreases LDL and not increases it (ruling out Option `b). Now we are left with 2 options, Option 'c' i.e. Bone mass and Option 'rile. Muscle mass. Estrogen given as hormone replacement therapy is most beneficial in preventing osteoporosis i.e it must be increasing bone mass. So, Option 'c'seems to be correct. Now have a look what texts have to say : Estrogen helps to maintain bone mass and skeletal integrity thereby protecting against osteoporosis. Effect of estrogen on bones : Estrogen causes increased osteoblastic activity in the bones. It is impoant in maintaining bone mass primarily by retarding bone resorption. The major action of estrogen is directed at reducing the maturation and activity of osteoclasts, by modifying regulatory cytokine signals from osteoblasts. The action of estrogen and progesterone result in increased expression of bone matrix proteins such as osteonectin, osteocalcin, collagen and alkaline phosphatase. Extra Edge : An overveiw of osteoporosis Risk factors for osteoporosis Non modifiable Modifiable Associated Medical Conditions * Age * Race (caucasian, asian) * Small body frame * Early menopause * Prior fracture * Family history of osteoporosis Inadequate intake of calcium and vitamin D Smoking Low body weight Excess alcohol use Sedentary lifestyle Hypehyroidism Hyperparathyroidism Chronic renal disease Conditions requiring systemic coicosteroid use Diagnosis : Bone Mineral Density Measurement (BMD) Dual X-ray Absorptiometry (DXA) of hip and spine is the primary technique for BMD assessment. BMD is expressed as a T score, which is the number of standard detions from the mean for a young healthy woman. A T score above --1 is considered normal, a value between --1 and --2.5 denotes osteopenia and a score below --2.5 indicates osteoporosis. Evaluation of BMD by DXA is recommended for all women aged 65 and older, regardless of risk factors and for younger postmenopausal women with 1 or more risk factors. Prevention : Women should receive 1000 to 1500 mg of calcium and 400 to 800 IU of vitamin D daily Options for osteoporosis prevention and treatment BisphosphonatesO Alendronate : 35 - 70 mg/week Risedronate : 35 mg/week lbandronate : 150 mg/month Additional potential benefits : none Potential risks : esophageal ulcers Side effects : gastrointestinal distress, ahralgia / myalgia Hormone therapy Estrogendeg or estrogen / progestin therapydeg Additional potential benefits : treatment of vasomotor symptoms and urogenital atrophy Potential risk : breast cancer, gallbladder disease, venous thromboembolic events, cardiovascular disease, stroke. Side effects : vaginal bleeding, breast tenderness Selective estrogendeg receptor modulators (SERMSP Raloxifenedeg : 60 mg/day Additional potential benefits : reduced risk of breast cancer Potential risks : venous thromboembolic events Side effects : Vasomotor symptoms, leg cramp Calcitonindeg : 200 IU/day intranasally or 100 IU/day subcutaneously or intramuscularly Additional potential benefits : non Potential risks : none Side effects : rhinitis, back pain Tariparatidedeg : 20 mg/day subcutaneously Additional potential benefits : none Potential risks : osteosarcoma after long - term use in rodents, hypercalcemia Side effects : leg cramps
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