What expected results are seen with estrogen therapy in low fracture risk populations?

Estrogen therapy in low fracture risk populations is expected to lead to a decrease in vertebral fractures. Estrogen plays a significant role in maintaining bone density and reducing bone resorption, which can help protect against fractures, particularly in the vertebrae. Since vertebral fractures can lead to serious health issues, including chronic pain and spinal deformities, the effect of estrogen therapy in this regard is particularly important in populations assessed to be at low risk for fractures overall.

While estrogen therapy has also been shown to increase bone density and may ultimately contribute to a reduction in hip fractures, its primary and most consistent impact has been observed in reducing the risk of vertebral fractures. In populations with a low risk of fractures, the preventive measures become even more nuanced, where the effects seen in higher-risk groups may not be replicated as strongly. Therefore, the focus on vertebral fractures highlights the specific benefits seen with estrogen therapy in this context.