Predicting the predisposition to osteoporosis. Gonadotropin-releasing hormone antagonist for acute estrogen deficiency test
R. Abbasi and G. D. Hodgen
A reliable predictive test to identify perimenopausal women who are
vulnerable to the adverse effects of severe estrogen deficiency may be
useful in deciding for whom and when to begin estrogen replacement therapy.
Primate models were employed to determine whether short-term treatment with
gonadotropin-releasing hormone antagonist allows prospective identification
of individuals at greatest risk for a negative calcium balance during overt
estrogen deficiency; whether high-dose clomiphene citrate is sufficiently
estrogenic to abate urinary calcium loss and to sustain vaginal and
perineal tissues after ovariectomy; and whether clomiphene citrate will
provide these beneficial estrogenic effects without inducing endometrial
proliferation and menstruation after progestin withdrawal. The data
indicate the capability of short-term gonadotropin-releasing
hormone-antagonist test to identify individuals likely to lose calcium
rapidly after ovariectomy. This result has potential usefulness in the
prediction of susceptibility to osteoporosis after medical castration or
spontaneous menopause. At high doses, clomiphene citrate therapy was nearly
as effective as high-dose conjugated equine estrogens for conservation of
urinary calcium, yet clomiphene citrate did not cause endometrial
proliferation or withdrawal bleeding after progesterone therapy.