EDITOR,We were pleased to see the publication on behalf of the UK Steering Group "Recommendations for the management of galactosaemia".¹ In particular, we were pleased to see the emphasis on the management of adult women and the prevention of osteoporosis. We have, however, some concerns about the advice on the use of Loestrin 20 (an oral contraceptive preparation containing 20 µg ethinyl oestradiol and a progestogen) for long term oestrogen replacement.

None of the combined oral contraceptive pills, such as Loestrin 20, are licensed for the prevention of osteoporosis, although until the more widespread use of hormone replacement therapy (HRT) preparations, many were widely used for this purpose. In addition to providing oestrogen, they have the advantage of being without prescription charge and are widely accepted, particularly by young adults.

There are disadvantages, however. The main one is the duration of therapy. Women taking combined oral contraceptive preparations receive only . . . [Full text of this article]