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Alternatives to the Use of Estrogen in Postmenopausal Women

Departments of Obstetrics/Gynecology and Endocrinology, The Women’s Place and the Cancer Center, University of Virginia Health Sciences Center, Charlottesville, Virginia 22903-9301

I. Introduction

II. Prevention of Cardiovascular Disease

A. Estrogens and primary prevention of cardiovascular disease

B. Comparison of statins with estrogens for primary prevention of cardiovascular disease

C. Effects of statins on new coronary events and survival

D. Other agents with potential for prevention of cardiovascular disease

E. Secondary prevention of cardiovascular disease

III. Prevention and Treatment of Osteoporosis

A. Estrogen therapy for osteoporosis

B. Bisphosphonates for prevention of osteoporosis

C. Nasal calcitonin for osteoporosis

D. SERMs for prevention of osteoporosis

E. Comparison among therapeutic agents for treatment of osteoporosis

IV. Urogenital Atrophy

V. Vasomotor Instability

A. Alternative/herbal therapy

VI. Central Nervous System (CNS) Symptoms

VII. Safety and Side Effects of Alternatives to Estrogen

VIII. Conclusions

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