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Even though it prevents fracture, HRT not recommended, say Pittsburgh researchers

PITTSBURGH, Sept. 26 Hormone therapy helps prevent bone fracture in women, but the benefit does not override the therapy's well-known negative links to heart disease and breast cancer, report University of Pittsburgh researchers in the October 1 issue of the Journal of the American Medical Association.

"Our study found that estrogen plus progestin increased the bone mineral density and decreased the risk of fracture in healthy postmenopausal women. However, when we analyzed hormone therapy's effects on health overall, we determined that hormone therapy has no benefit to women, even those at high risk of fracture," said lead author and principal investigator Jane Cauley, Dr.P.H., professor of epidemiology at the University of Pittsburgh. "We do not recommend use of hormone therapy for any purpose other than short-term relief of menopausal symptoms."

The study, part of the Women's Health Initiative (WHI), included 16,608 participants ages 50 to 79 years, half of whom took estrogen plus progestin, and half of whom took placebo, for five years. During that time, 733 women in the hormone therapy group experienced a fracture, while 896 women in the placebo group had a fracture. Also, hip bone mineral density a measurement of bone strength increased by nearly 4 percent in the hormone therapy group, compared with a 0.14 percent increase in the placebo group.

The results were consistent in women who were considered at low, medium and high risk of fracture based on their risk factors, which included age, body mass index, smoking, history of falls, calcium intake, personal and family history of fracture and past use of hormones.

But when researchers examined the overall effects of hormone therapy as summarized in the global index created by WHI researchers in 2002, they determined that the benefit of fracture reduction does not outweigh the risks, even for women at high risk of fracture.

"Considering the overall unfavorable effec
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Contact: Kathryn Duda
412-647-3555
University of Pittsburgh Medical Center
30-Sep-2003


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