Estrogen's Benefit on Bone Questioned
Estrogen's Benefit on Bone Questioned
June 12, 2001 -- The main reason the majority of women take hormone replacement therapy after menopause is to prevent the crippling brittle-bone disease osteoporosis as they age. But new research adds to growing concerns that taking estrogen may not be the most effective protection for women over age 60.
Over the years, numerous studies have shown consistently that estrogen taken after menopause prevents bone loss, which lessens the risk of fractures of the spine, hip, and elsewhere.
But some studies, including one of the largest ever conducted of postmenopausal women taking hormone replacement therapy, found no evidence that it prevented fractures. In fact, the FDA, which once approved of estrogen as a treatment for osteoporosis, no longer supports that idea.
According to David J. Torgerson, PhD, the reason for the conflicting findings may be that the timing of the initiation of hormone replacement therapy predicts whether it will help prevent bone loss and fractures.
In a study published in the June 13 issue of The Journal of the American Medical Association, Torgerson and colleagues report that hormone replacement therapy appears to reduce overall nonvertebral fractures by about 35%, and hip and wrist fractures by about 50% -- but only when women start taking the therapy before the age of 60.
All the studies he could find of women who started taking the therapy after age 60 showed no significant preventive effect.
"If you start [hormone replacement therapy] soon after your menopause, by about 55 years old, up to age 60, our results suggest it is effective at preventing having a fracture," says Torgerson, of the University of York in Heslington, U.K. "If you're over age 60, it would seem that the evidence isn't as strong that it works. ... You might be better to consider an alternative medication where there is better evidence of effectiveness."
Those alternatives include drugs that have been proven effective for preventing and treating osteoporosis such as Evista, Fosamax, Actonel, and the hormone calcitonin.
Torgerson tells WebMD there are a number of studies ongoing in both the U.S. and the U.K. that are attempting to further clarify the role of estrogen in preventing osteoporosis, but until those results are in, women should probably choose a non-estrogen drug for prevention if they are older than 60 and haven't previously taken estrogen.
Estrogen's Benefit on Bone Questioned
June 12, 2001 -- The main reason the majority of women take hormone replacement therapy after menopause is to prevent the crippling brittle-bone disease osteoporosis as they age. But new research adds to growing concerns that taking estrogen may not be the most effective protection for women over age 60.
Over the years, numerous studies have shown consistently that estrogen taken after menopause prevents bone loss, which lessens the risk of fractures of the spine, hip, and elsewhere.
But some studies, including one of the largest ever conducted of postmenopausal women taking hormone replacement therapy, found no evidence that it prevented fractures. In fact, the FDA, which once approved of estrogen as a treatment for osteoporosis, no longer supports that idea.
According to David J. Torgerson, PhD, the reason for the conflicting findings may be that the timing of the initiation of hormone replacement therapy predicts whether it will help prevent bone loss and fractures.
In a study published in the June 13 issue of The Journal of the American Medical Association, Torgerson and colleagues report that hormone replacement therapy appears to reduce overall nonvertebral fractures by about 35%, and hip and wrist fractures by about 50% -- but only when women start taking the therapy before the age of 60.
All the studies he could find of women who started taking the therapy after age 60 showed no significant preventive effect.
"If you start [hormone replacement therapy] soon after your menopause, by about 55 years old, up to age 60, our results suggest it is effective at preventing having a fracture," says Torgerson, of the University of York in Heslington, U.K. "If you're over age 60, it would seem that the evidence isn't as strong that it works. ... You might be better to consider an alternative medication where there is better evidence of effectiveness."
Those alternatives include drugs that have been proven effective for preventing and treating osteoporosis such as Evista, Fosamax, Actonel, and the hormone calcitonin.
Torgerson tells WebMD there are a number of studies ongoing in both the U.S. and the U.K. that are attempting to further clarify the role of estrogen in preventing osteoporosis, but until those results are in, women should probably choose a non-estrogen drug for prevention if they are older than 60 and haven't previously taken estrogen.