DESCRIPTION

One of the biggest causes of osteoporosis (with breaks and bony crushings) is the menopause.

There are two types of osteoporosis with patogenia (mechanisms of production) different.

• Type I related one to the shortcoming of estrogen. It happens between the 50 and 70 years of age and can lead to breaks and crushings of the column.
• Type II Happens from 70 years of age and collaborates to breaks of hip and column.

  Column with        Normal Osteoporosis      C  olumna

In the type II finds low in blood the Vitamin D and diminishes the Calcium absorption for the bones, being this factor more important than in the type I (deficit of estrogen). Also a light hormone decrease appears paratiroidea.

In the young people the bone formation is major than the destruction and the mineral content increases. On the adult both processes balance, and after 50 years the reabsorption is major than the formation therefore the bony thickness diminishes.

In the women the loss of estrogen, for the menopause, follows of 10 years of acceleration of the bony destruction and of the thickness of the bone. Although the increase of the breaks not always is correlated well with the decrease of the bony thickness. The connection of these facts is difficult. Several factors influence the osteoporosis at this age, in addition to the estrogen deficit: smoking, the thinness, the sedentary life, the low contribution of calcium and other genetic and constitutional factors (the osteoporosis is minor in the black race).

The estrogen is the most effective treatment in the osteoporosis postmenopaúsica.

His action mechanism is not known and it is more antireabsobente that osteoblástico, for it it is effective. If the treatment is put on time diminuyen the breaks risks.

The effective dose is 0,625 mg of brought together estrogénico. This dose is major than the effective one in the treatment of the cutaneous Flush (to become red), but it is necessary and effective, in addition to being free of side effects.

Between the disadvantages there is the one that after 2 years produces an endometrio hypertrophy, bled vaginal and of 3 to 8 % of increase of cancer of endometrio.

It is possible to compensate with medroxyprogesterona rules 2.5 to 10 mg a day, 10 days every month. As this rule re-introduces the rules, must be evaluated by the patient.

In favor of taking hormones estrogénicas it is the case of a woman:

• thin
• sedentary
• smoker
• to that the womb was extirpated

Against giving hormones it is the case of a woman:

• with obesity
• much it activates physically
• with problems of thrombosis
• breast cancer precedents

Smoking or the capture of (antiulcer) cimetidina annuls the beneficial effect of the estrogen.

Also there can be useful the capture of supplements of calcium (1.000 mg / day if it takes estrogen; 1.500 mg / day if it does not take them).

As control test uses the bony densitometría.

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