Hormone Therapy May Prevent Bedsores

Treatment found to cut risk of leg ulcers in elderly women

FRIDAY, Feb. 22, 2002 (HealthDayNews) -- Besides easing the symptoms of menopause, hormone replacement therapy may also help keep your skin healthy.

The latest study on the potential benefits of hormone replacement therapy (HRT) found the treatment might help prevent leg ulcers and bedsores. Results of the study appear in tomorrow's issue of The Lancet.

"Women on HRT were about 40 percent less likely to develop either leg ulcers or pressure ulcers," says lead author Dr. David Margolis, an associate professor of epidemiology and dermatology at the University of Pennsylvania.

Venous leg ulcers refer to a break in the skin on the leg. This type of injury occurs in about 1 percent of people over 65, says Margolis. They occur most often in people with poor circulation, and the older you get, the higher your risk for developing these painful sores.

Pressure ulcers are commonly known as bedsores. They occur in between 0.1 percent to 0.5 percent of the population over 65, according to Margolis. However, in long-term care settings like nursing homes, that number can go as high as 20 percent. Pressure ulcers also develop from a lack of circulation, but can be helped by adjusting bedridden patients' positions often. Anyone who is not mobile is at risk for pressure ulcers.

Margolis and his colleagues studied data from 44,195 women in the United Kingdom, all of whom were 65 or older. Almost 5,000 of the women were on hormone therapy for six months or more.

Only 108 of the women on HRT developed venous leg ulcers, while 1,744 women in the whole group had the condition. Of the 802 women with pressure ulcers, only 49 of them were women on HRT, the study found.

Using HRT resulted in decreased risk of both venous leg ulcers and pressure ulcers by between 30 percent and 40 percent. The amount varied slightly due to age, type of ulcer and other conditions such as diabetes or heart disease. For example, women on HRT with diabetes had a 36 percent reduced risk of venous leg ulcers and a 32 percent decrease in the likelihood of getting pressure ulcers.

Margolis says these results only suggest a possible association between HRT and prevention of leg ulcers. He says he doesn't know why the hormones would have this effect, and says it is way too soon to recommend that women take HRT to prevent leg ulcers. He also says there could be other factors that account for the decreased risk. For example, he says, it could be that only younger women in the study were put on HRT.

At least one dermatology expert also doubts the association.

"I think it's a nice observation, but it may be coincidental," says Dr. Bijan Safai, chairman of dermatology for New York Medical College in Valhalla. Because these types of ulcers are caused by decreased circulation, Safai explains HRT would have to improve a patient's circulation to have this effect, and he doesn't believe HRT has that capability.

What To Do

If you already have venous leg ulcers, there's not much you can do to prevent them except to wear special compression stockings. To prevent them from ever developing, regular exercise can help, says Safai.

To learn more about pressure ulcers, go to Healthpages.org. The NetDoctor offers details on venous leg ulcers.

SOURCES: Interviews with David Margolis, M.D., associate professor, epidemiology and dermatology, University of Pennsylvania, Philadelphia; Bijan Safai, M.D., chairman, department of dermatology, New York Medical College, Valhalla; Feb. 23, 2002, The Lancet
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