Why it s not hip to halt hormone replacement therapy

A new study in the journal Menopause shows that the benefits of hormone replacement therapy aren t just hypothetical. Researchers at the University of Southern California found that the nearly 81,000 postmenopausal women who discontinued their hormone replacement therapy were at a much greater risk of a hip fracture due to lowered bone density, as compared to those who continued on the preventive regimen. The finding is important because, as lead author Dr. Roksana Karim points out, while it s been known for some time that post-menopausal women who don t take hormone replacement therapy have a greater risk of suffering a bone fracture, it s now evident that halting such hormone therapy also results in an increased risk.

The women in the study were at least 60 years of age and had filled a prescription for hormone replacement therapy at least once between January and June 2002. Over the six and a half years they were followed, the annual hip fracture rate increased from 3.9 to 5.6 per 1,000 women an almost 50 percent increase. The risk increased as early as two years after hormones were stopped, and it kept rising incrementally, climbing from 52 to 77 percent.

These findings are especially important to heed since, following the flawed but widely publicized Women s Health Initiative (WHI) study of 2002, many women have become hesitant to use hormone replacement therapy. ACSH's Dr. Ross reiterates that the risk of heart disease and cancers that the WHI study associated with hormone replacement therapy is very low, and the benefits for both menopausal symptoms and bone health are significant and difficult to substitute for. As in all instances of this kind, he says, patients and doctors need to discuss the relative risks and benefits. However, this most recent study is a clear indication of the risks associated with not adhering to hormone replacement therapy.