Update on Hormone Replacement: Sorting Out the Options for Preventing Coronary Artery Disease and Osteoporosis

, Ohio State University

In This Article


Table I - Oral Estrogens

Drug Lower Dose Standard Dose Higher Dose
Conjugated equine estrogen (Premarin) 0.3mg 0.625mg qd 0.9mg 1.25mg 2.5mg
Micronized estradiol (Estrace) 0.5mg 1.0mg qd or 0.5mg bid -- 2.0mg --
Estrone (Ogen) -- 0.625mg qd -- 1.25mg 2.5mg
Estrone (Ortho-est) -- 0.625mg qd -- 1.25mg --

Table II - Estrogen Patches (Transdermal Estradiol

Type of Drug Interval Lower Dose Usual Minimum Dose Higher Dose Patch Change Interval
Transdermal estradiol reservoir system (Estroderm) -- 0.05mg 0.10mg Every 3 1/2 days
Transdermal estradiol matrix system (Vivelle) 0.0375mg 0.05mg 0.075-0.10mg Every 3 1/2 days
Transdermal estradiol matrix system (Climara) -- 0.05mg 0.10mg Weekly

Table III - Hormone Replacement Therapy

Benefit Risk
Relief of vasomotor symptoms. Acceleration of an already existing breast cancer.
Prevention of postmenopausal osteoporosis, fractures. Endometrial cancer risk increases 5- to 10-fold if estrogen is unopposed.
Reduction of cardiovascular risk. PMS-like side effects with progestin-estrogen program.
Reversal of genitourinary atrophy. Increased incidence of gallbladder disease.
Possible improvement in mood, energy, and recent memory  


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