MENOSTAR^® is indicated for the prevention of osteoporosis in postmenopausal women. Before prescribing MENOSTAR, nonestrogen medications should be carefully considered. Therapy with MENOSTAR should be considered only for women at significant risk of osteoporosis.

The following are examples of patients who are at risk of osteoporosis and for whom MENOSTAR may be indicated.

Patient JG

• Age: 65
• Weight: 134 lbs.
• Race: Caucasian
• VMS: Estrogen and progestin therapy for symptom relief; symptoms currently subsided
• Date of last menstrual cycle: 1992
• Oophorectomy/Hysterectomy: No
• Risk Factors for osteoporosis:
  • Family history of osteoporosis;
  • 25-year, 1 pack-per-day history of cigarette smoking;
  • Moderate alcohol intake
• Labs: Endocrinological evaluation
  • Elevated alkaline phosphatase
  • Elevated levels of serum calcium
  • Elevated levels of osteocalcin
  • Mildly elevated 25-hydroxy vitamin D
• CBC: Normal
• Dual-energy x-ray absorptiometry (DEXA):
  • Lumbar spine T-score = -1.60;
  • Femoral neck T-score = -1.22;
  • Radius T-score = -1.01

The remainder of the evaluation was within normal limits.

Patient JG’s DEXA results placed her in the osteopenia range. Because of her significant risk factors for osteoporosis, including family history, MENOSTAR^® (estradiol transdermal system) is a therapeutic choice.

Therapy with MENOSTAR should be considered only for postmenopausal women at significant risk of osteoporosis. Before prescribing MENOSTAR, nonestrogen medications should be carefully considered.

This case represents the experience of a fictional patient. Not all patients will have a similar experience.

Patient MC

• Age: 68
• Weight: 111 lbs.
• Race: Asian
• VMS: none
• Date of last menstrual cycle: 1990
• Oophorectomy/Hysterectomy: Yes
• Risk Factors for osteoporosis:
  • Asian descent;
  • Family history;
  • Low calcium/vitamin D intake;
  • Fracture of wrist at age 54
• Labs: Endocrinological evaluation
  • Slightly elevated levels of serum calcium
  • Elevated levels of osteocalcin
  • Mildly elevated 25-hydroxy vitamin D
• CBC: Normal
• Dual-energy x-ray absorptiometry (DEXA):
  • Lumbar spine T-score = -2.36;
  • Femoral neck T-score = -2.08;
  • Radius T-score = -1.89

The remainder of her tests are within normal limits.

Patient MC’s DEXA results placed her in the osteopenia range. Because she is at significant risk for osteoporosis, including being of Asian descent, MENOSTAR^® (estradiol transdermal system) is a therapeutic choice.

Therapy with MENOSTAR should be considered only for postmenopausal women at significant risk of osteoporosis. Before prescribing MENOSTAR, nonestrogen medications should be carefully considered.

This case represents the experience of a fictional patient. Not all patients will have a similar experience.

Patient RP

• Age: 61
• Weight: 129 lbs.
• Race: Hispanic
• VMS: HRT > 5 years ago; no current VMS
• Date of last menstrual cycle: 1987
• Oophorectomy/Hysterectomy: Yes
• Risk Factors:
  • 22-year, 1 pack-a-day history of smoking;
  • Previous history of anorexia nervosa;
  • Compression fracture of the spine;
  • Inactive lifestyle;
  • Estrogen deficiency;
  • Low intake of calcium and vitamin D.
• Labs: Endocrinological evaluation
  • Low levels of serum calcium
  • Elevated levels of osteocalcin
  • Low levels of 25-hydroxy vitamin D
• CBC: Normal
• BP: 168/100
• Dual-energy x-ray absorptiometry (DEXA):
  • Lumbar spine T-score = -2.74;
  • Femoral neck T-score = - 2.22;
  • Radius T-score = -2.69 

MENOSTAR^® (estradiol transdermal system) is not indicated in this case because patient RP currently has a diagnosis of osteoporosis. Therefore she should be given a therapy appropriate for the treatment of osteoporosis.

This case represents the experience of a fictional patient. Not all patients will have a similar experience.

Patient CA

• Age: 62
• Weight: 121 lbs.
• Race: Caucasian
• VMS: none
• Date of last menstrual cycle: 1991
• Risk Factors:
  • Family history of osteoporosis;
  • Low calcium and vitamin D intake;
  • Low BMD
• Oophorectomy/Hysterectomy: No
• Labs: Endocrinological evaluation
  • Age-normal levels of serum calcium
  • Age-normal levels of osteocalcin
  • Mildly elevated 25-hydroxy vitamin D
• CBC: Normal
• Dual-energy x-ray absorptiometry (DEXA):
  • Lumbar spine T-score = - 0.92
  • Femoral neck T-score = -0.65;
  • Radius T-score = - 0.93

The remainder of her tests are within normal limits.

Patient CA’s DEXA results place her in the normal range. However, because of a family history of osteoporosis, she should remain under careful observation in the future. No recommendations other than increased calcium and vitamin D intake and a program of weight-bearing exercise, such as walking, are indicated at this time. Should her DEXA scores fall in the osteopenia range as she ages, patient CA may be a candidate for MENOSTAR^® (estradiol transdermal system).

MENOSTAR is indicated for the prevention of postmenopausal osteoporosis.  Therapy should be considered only for women at significant risk of osteoporosis. Non-estrogen medications should be carefully considered.