Treatment of Osteoporosis

To the Editor: Richelson et al. (Nov. 15 issue)1 make an important point about postmenopausal osteoporosis: the presence of estrogen helps prevent bone loss. But why is estrogen effective? Is it the most effective hormonal treatment? As Nuti and co-workers2 have shown, anabolic steroids have an even more pronounced effect and can in fact produce a prolonged increase in bone calcium in postmenopausal patients. It would appear that estrogen's osteogenic effects occur not because of its estrogenic properties themselves but because it is also weakly anabolic. This helps explain why women slowly lose bone calcium even with normally functioning ovaries,.