Toward Optimal Estrogen-Replacement Therapy

Abstract

Some of the many paradoxes about estrogen therapy are addressed by Ross et al. in this issue of the Journal.¹ Their studies consider the optimal dose of ethinyl estradiol to promote growth, and they are relevant to a more general question: Why is the outcome of the usual estrogen therapy often less satisfactory than that of normal feminization?Many of our problems with estrogen treatment can be understood from a historical perspective. Early researchers did not have ready access to indexes more sophisticated than uterine weight. Estrogen doses that greatly stimulated uterine growth were found to inhibit somatic growth. . . .