Long-term gonadotropin-releasing hormone agonist with standard postmenopausal estrogen replacement failed to prevent vertebral bone loss in premenopausal women.

If indeed younger women do not receive bone protection from standard postmenopausal hormone replacement, these women may also be at increased risk for heart disease, urogenital atrophy, and other effects of long-term hypoestrogenism with 0.625 mg of CE add-back. We recommend that until long-term studies using BMD of the lumbar spine are available, 1.25 mg of CE or the equivalent dosage of other Es be prescribed when planning long-term GnRH-a ovarian suppression.