How is pharmacotherapy of hyperPTH?

-Estrogen therapy in postmenopausal women has been shown to cause a small reduction in serum Ca (0.5-1 mg/dL) without a change in PTH -Estrogen also has beneficial effects of lumbar spine and femoral neck bone mineral density (BMD) -Bisphosphonates, in particular alendronate, has been shown to improve the BMD at the spine and hip BMD in patients with PH -Calcimimetic drugs activate the Ca-sensing receptor and inhibit parathyroid cell function -Treatment with cinacalcet resulted in reduction without normalization of PTH levels, reduction and even normalization of serum Ca, but no increase in BMD was observed