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          Abstract

          Selective estrogen receptor modulators (SERMs) exhibit varying agonist/antagonist activities on estrogen receptors in tissues, although most SERMs, including ospemifene, have agonist effects on bone. In this article, outcomes in relation to bone homeostasis, bone mineral density (BMD), and osteopenia–osteoporosis are examined in postmenopausal women during treatment with ospemifene for vulvar and vaginal atrophy (VVA), a component of the genitourinary syndrome of menopause. In cases 1 and 2, the women had established osteopenia or osteoporosis before the start of ospemifene treatment. After 6 months’ and 7 months’ treatment, respectively, marked reductions were observed in bone resorption (decreased levels of carboxy-terminal cross-linking telopeptide of type-1 collagen). The woman in case 3 had normal bone marker data and BMD prior to starting treatment with ospemifene. After 1 year, bone biomarkers and densitometry indicated improved bone health. Ospemifene 60 mg daily for treatment of VVA in postmenopausal women appears to benefit bone health although, because current evidence is based mainly on bone biomarkers, long-term studies are required to confirm this potential.

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          Hormone-replacement therapy: current thinking

          Roger Lobo (2016)
          Clinical practice regarding the use of hormone-replacement therapy (HRT) has undergone many changes since its introduction in the 1940s. Here, Roger Lobo frames the current thinking on the use of HRT in postmenopausal women, beginning with a historical perspective and then discussing how the interpretation of HRT data has changed over time.
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            Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives

            Bone biomarkers included formation, resorption and regulator are released during the bone remodeling processes. These bone biomarkers have attracted much attention in the clinical assessment of osteoporosis treatment in the past decade. Combination with the measurement of bone mineral density, the clinical applications of bone biomarkers have provided comprehensive information for diagnosis of osteoporosis. However, the analytical approaches of the bone biomarkers are still the challenge for further clinical trials. In this mini-review, we have introduced the functions of bone biomarkers and then recently developed techniques for bone biomarker measurements have been systematically integrated to discuss the possibility for osteoporosis assessment in the early stage.
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              Urogenital ageing: an old problem newly recognized.

              Urogenital symptoms associated with estrogen loss can occur episodically throughout a woman's life (e.g. during lactation, during treatment with GnRH agonists, etc.) but it is most common and chronic in duration in postmenopausal women. More than 50% of postmenopausal women experience lack of vaginal lubrication and frequent vaginal infections [1]. These urogenital complaints were associated with a diminished frequency of all forms of sexual behaviour. Complaints associated with urogenital ageing include vaginal dryness, irritation and pressure, vaginal discharge and infection, vulvo-vaginal pruritus, dyspareunia, post-coital bleeding, urinary frequency, urgency and incontinence and recurrent urinary tract infections. Although these symptoms have affected women for centuries, they are now becoming more widely recognized by health professionals and society in general because of the increased life expectancy, the acceptance of open discussion of this topic, and the advent of effective therapy. Urogenital ageing is a public health issue because of its high prevalence and because early detection and pharmacological intervention may prevent the development of serious conditions such as uterine prolapse and urinary incontinence. Although systemic hormone replacement therapy is frequently used for the treatment of urogenital atrophy, recent attention has also focused on local delivery of estrogen to the affected urogenital tissue. In this era of fiscal constraint, intervention to maintain urogenital health by the use of estrogen must be considered for all postmenopausal women.
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                Author and article information

                Journal
                Drugs Context
                Drugs Context
                DIC
                Drugs in Context
                BioExcel Publishing Ltd
                1745-1981
                1740-4398
                2020
                01 July 2020
                : 9
                : 2020-3-3
                Affiliations
                [1 ]Ginecología y Obstetricia, Hospital Quirónsalud San José, Madrid, Spain
                [2 ]Policlínico HM Gabinete Velázquez, Madrid, Spain
                [3 ]Palacios’ Institute of Women’s Health, Madrid, Spain
                Author notes
                Correspondence: María del Carmen Pingarrón Santofimia, Ginecología y Obstetricia, Hospital Quirónsalud San José, C/Cartagena, 111, 28002 Madrid, Spain. cpingarrons@ 123456gmail.com
                Article
                dic-2020-3-3
                10.7573/dic.2020-3-3
                7337603
                f9a765ac-ab03-4e06-a825-a4dec24c3cff
                Copyright © 2020 Pingarrón Santofimia MC, González Rodríguez SP, Lilue M, Palacios S.

                Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

                History
                : 20 March 2020
                : 20 May 2020
                : 21 May 2020
                Categories
                Case Report

                bone biomarkers,bone homeostasis,ospemifene,vulvar and vaginal atrophy

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