No bones about it: HRT prevents hip fractures

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ACSH staffers have long known that the adverse health effects of hormone replacement therapy (HRT), according to the 2002 Women s Health Initiative study, were dramatically overstated. Despite this, the public response to this report was drastic: Based on the widely publicized results of that research, 93 percent of U.S. women ceased using HRT or did not obtain a new prescription.

However, we now know that information extracted from that study exaggerated the risk of HRT increasing a woman s chances of developing breast cancer and cardiovascular disease. As ACSH's Dr. Gilbert Ross explains, these increases were confined to women who had used HRT for more than five years and begun treatment later, extending its use often past age 60. In actuality, he adds, women who use the treatment at least the estrogen-only type, without progesterone for about two to four years at the onset of menopause may see a reduced risk of breast cancer.

Now, a new study published in the journal Menopause further tips the balance in favor of HRT by confirming its well-known benefits to bone health. After analyzing data from over 50,000 women enrolled in Southern California Kaiser Permanente HMO plans, researchers from the University of Southern California found that women who discontinued HRT had a 55 percent increased risk of hip fracture, compared to women who continued on the hormone therapy.

As Dr. Ross points out, There s nothing better than hormone therapy for the relief of menopausal symptoms, and now we see more evidence not that any more was needed that it also drastically improves bone health. So that when such treatment is stopped, conditions like osteoporosis and hip fractures come back with a vengeance.

ACSH's Dr. Josh Bloom adds, I wish people had more carefully considered the risks and benefits of the treatment in 2002. The press had women so terrified of HRT, that most stopped immediately and now the fallout has become clearer, with many women being harmed.

Indeed, hip fractures are a major health concern over 300,000 cases are reported annually in the U.S. About a quarter of women who suffer such a fracture will die within a year, while another quarter will require long-term care and half will experience long-term loss of mobility.

This is a devastating condition, says Dr. Ross. "Menopausal women should be counseled about the potential benefits of the appropriate use of HRT for countering the effects of osteoporosis. Women who smoke, those with a family history of fracture, and especially those who have suffered previous bone fractures, are all at an increased risk for the condition, and should be especially aware of the benefits of hormone therapy.