Bone Up on Hormone Replacement Therapy
WebMD News Archive
"This does not in any way change my mind about the
potential benefits of HRT or estrogen in preventing fractures," says
Recker, who is director of the Osteoporosis Research Center at Creighton
University School of Medicine in Omaha, Neb. He says that many other studies
have shown that HRT increases bone mass and that a few studies have shown that
the therapy also can reduce the risk of fractures.
Recker says in addition to those, other studies suggest that
the estrogenlike drug raloxifene, which is sold as Evista, is very effective at
reducing the risk of spine fractures. Since estrogen and Evista work similarly,
he says there's no reason to believe that estrogen would be any less effective
at reducing fractures when taken for five years or more.
The biggest problem, he says, is that almost no studies have
looked at postmenopausal women long enough to determine whether estrogen or
estrogen plus progestin leads to fewer fractures as they age. One ongoing study
-- the Women's Health Initiative -- is attempting to do this, but it is not
scheduled to be completed until 2004.
"We just have to wait. I think the evidence is pretty clear
that estrogen will slow or prevent bone loss. Now, whether over the years that
will translate into fracture reduction, nobody knows," says C. Conrad
Johnston Jr., MD, president of the board of trustees of the National
Osteoporosis Foundation and a professor of medicine at Indiana University
School of Medicine in Indianapolis. "But the evidence suggests that the
earlier you take it, the more of an effect it will have."
Johnston says his advice to women wondering about whether to
start or continue taking hormones to prevent fractures is, "don't throw the
baby out with the bathwater" based on this study alone.
According to the National Osteoporosis Foundation, 8 million
women in the U.S. have osteoporosis, which puts them at significantly increased
risk for bone fractures as they age. Another 14.4 million women have low bone
mass, which also increases the risk of fractures.