Androgens and bone: clinical implications for menopausal women.

Osteoporosis is a common problem, affecting >28 million Americans, >/=75% of whom are postmenopausal women. In 1995 the cost of caring for patients with complications of osteoporosis was $14 billion. Of the 1.5 million osteoporotic fractures that occur in this country each year, the most serious are hip fractures. It is estimated that approximately 10% to 20% of women die within a year after a hip fracture. Numerous studies reveal that although osteoporotic fractures are preventable most women are not receiving or choosing to receive the medical care that they need to prevent them. Great strides have been made in establishing the importance of ovarian hormones in not only the pathophysiology but also the treatment of postmenopausal osteoporosis. Clinical studies show that estrogen and estrogen-androgen replacement therapies both prevent the development of osteoporosis, as determined by bone mineral density determinations and bone marker analyses. The addition of an androgen to hormone replacement therapy may prevent bone loss and stimulate bone formation.