Hormone Therapy Reduces Fracture Risk

Benefit disappears quickly when therapy is stopped

TUESDAY, May 11, 2004 (HealthDayNews) -- Although hormone replacement therapy (HRT) has come under fire lately because of negative findings in large studies, a new British study reports some good news for users.

In the May 12 issue of the Journal of the American Medical Association, British researchers report that hormone replacement can reduce the risk of a bone fracture by almost 40 percent in postmenopausal women. However, the protection stops when the therapy stops.

"Current use of HRT protects against fracture, regardless of which type of HRT is in use, but these beneficial effects wear off soon after women stop taking it," said the study's lead author, Emily Banks, who was deputy director of the Cancer Research U.K. epidemiology unit in Oxford when the research was done.

Major studies in the last two years have shown that HRT may increase the risk of blood clots, heart disease, strokes, some cancers and gall bladder disease for some women. Additionally, according to the U.S. Food and Drug Administration, there is no convincing evidence that HRT can help prevent Alzheimer's disease.

Against that bleak background comes the current study, which involved 138,737 postmenopausal women between the ages of 50 and 69. Almost 5,200 women reported suffering from at least one fracture during the study, which lasted almost four years. Seventy-nine percent of the fractures were the result of a fall.

Slightly more than 70,000 women in the study had never used any type of hormone replacement therapy, while 22,318 women were former users of HRT. More than 46,000 women were current users of HRT. The women taking HRT were on various forms of hormone therapy, such as estrogen only, or an estrogen/progesterone combination, and they were on varying doses of the medication as well.

Despite these differences, the researchers found that women who were currently using HRT had a 38 percent reduced risk of bone fractures compared to women who had never used HRT.

"Among current users of HRT, the degree of protection against fracture increased significantly with increasing duration of use," said Banks.

But she cautioned, "The protective effect of HRT against fracture wears off rapidly after women stop using it."

Banks said a likely reason HRT offers this benefit is that it is know to increase bone mineral density.

"This study is good evidence that hormone therapy has multiple benefits," said Dr. Luana Kyselka, a gynecologist and reproductive endocrinologist at Beaumont Hospitals in Michigan. "It is the best treatment for controlling menopausal symptoms, and it also helps protect bone."

Dr. Diana Curran, an obstetrician and gynecologist at the University of Nebraska Medical Center, said this study confirms what other studies have found.

"I don't think it would be the only reason to take hormones, but if you're on hormone therapy for other reasons, it's a nice side benefit," she added.

In another women's health study in the same issue of the journal, researchers from the University of California, San Francisco and the University of North Carolina reviewed the results of 13 studies that included thousands of women and looked at the effects of cholesterol-lowering drugs on cardiovascular disease and mortality.

They found that while lowering cholesterol -- either through diet or medication -- reduced the risk of a cardiovascular event in women without cardiovascular disease, these medications didn't reduce the overall risk of mortality from cardiovascular disease for women without heart disease.

In women with known heart disease, however, treatment of high cholesterol reduced the number of cardiovascular events and cardiovascular mortality rates. The mortality rate from all causes wasn't significantly affected by treatment for high cholesterol.

More information

To learn more about hormone replacement therapy, go to the American College of Obstetricians and Gynecologists or the National Institute on Aging. For more information on how aging affects your bones, go to the National Library of Medicine.

SOURCES: Emily Banks, Ph.D., fellow, National Centre for Epidemiology and Population Health, Australian National University, Canberra; Diana Curran, M.D., obstetrician and gynecologist, and assistant professor of obstetrics and gynecology, University of Nebraska Medical Center, Omaha; Luana Kyselka, M.D., gynecologist and reproductive endocrinologist, Beaumont Hospitals, Royal Oak and Troy, Mich.; May 12, 2004, Journal of the American Medical Association
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