Is vagifem helpful or otherwise a negative factor for a 67 yr. old woman with osteoporosis?

Vagifem: Vagifem really is just really an estrogen for atrophic vaginitis. However, taking systemic estrogen like estradiol, premarin, (conjugated estrogens) vivelle dot, etc does have the effect of increasing bone density and preventing osteoporosis. Once you have osteoporosis though, you are best off using a medication specifically for it like fosamax, actonel, forteo, etc.

Neither: The amount of estrogen that is absorbed into your circulation (and therefore helpful to your bones) is quite minimal with vagifem. That is both it's benefit (the estrogen stays local) and the limit (it doesn't get into the circulation). So - vagifem will neither help nor hurt your osteoporosis. Good luck!