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CME Release Date: August 2004 CME Expiration Date for Credit: August 31, 2006 Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Dannemiller Memorial Educational Foundation and Dowden Health Media. The Dannemiller Memorial Educational Foundation is accredited by the ACCME to provide continuing medical education for physicians. Designation of Credit: The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1 category 1 credit toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he she actually spent in the activity. This program has been approved for 1.8 contact hours of continuing education by the American Academy of Nurse Practitioners. Program ID 0408293. AANP Release Date: August 2004 AANP Expiration Date for Credit: August 31, 2005 Statement of Need: The efficacy of estrogen therapy for the prevention of postmenopausal osteoporosis remains undisputed after decades of experience with its use. However, with the advent of other pharmacologic options, such as bisphosphonates and selective estrogen receptor modulators, estrogen's benefits on skeletal health are often overlooked. Healthcare professionals interested in optimal approaches to osteoporosis prevention in postmenopausal women need to understand the consequences of low estrogen levels on bone, and the importance of restoring those levels to physiologic ranges through the use of lower-than-standard doses of estrogen in order to effectively preserve bone without inducing other adverse health outcomes. Intended Audience: This activity is intended for obstetricians, gynecologists, nurse practitioners, and other healthcare professionals interested in the prevention of osteoporosis in postmenopausal women. Learning Objectives: Upon completion of this activity, the participant should be able to: Identify risk factors that contribute to bone loss, especially in menopause Review the history of estrogen use for the prevention of osteoporosis Describe the role of newer estrogen therapy options, including lower doses and transdermal administration in the prevention of osteoporosis Review data on a new ultra-low-dose transdermal estrogen option for the prevention of osteoporosis in women Examine how a state of estrogen deficiency versus insufficiency may impact therapeutic outcomes Faculty Disclosure: The Dannemiller Memorial Educational Foundation requires that the faculty participating in a continuing medical education activity disclose to participants any significant financial interest or other relationship 1 ; with the manufacturer s ; of any commercial product s ; and or provider s ; of commercial services discussed in an educational presentation and 2 ; with any commercial supporters of the activity. The presenting faculty reported the following: Dr Ettinger is a consultant for, or receives research grants from Berlex, Inc., Eli Lilly & Company, Merck & Co., Inc., and Procter & Gamble Pharmaceuticals. Dr Lindsay is a consultant for Berlex, Inc., Aventis Pharmaceuticals, and Procter & Gamble Pharmaceuticals. He receives research support from Aventis Pharmaceuticals, Procter & Gamble Pharmaceuticals, and Wyeth-Ayerst Pharmaceuticals. Dr Simon is a consultant for Abbott Laboratories, Barr Laboratories, Berlex.

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