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Estrogen replacement not the cure-all for osteoporosis

Review on November 05, 2009

The 2002 study "Osteoporosis and Fractures in Postmenopausal Women Using Estrogen" by Heidi D. Nelson et al. explores the effect that estrogen replacement therapy has on cutting down osteoporosis related fractures and bone mineral loss. The estrogen loss that takes place during menopause is what causes women to suffer from osteoporosis at a higher rate than men. Women are estimated to bear eighty percent of the economic burden caused by osteoporosis. The link between low estrogen levels and bone loss has been proven beyond a doubt. The lack of estrogen in a woman's body after menopause causes half of all postmenopausal women to have suffered an osteoporosis-related fracture at some point in their lives. Hormone replacement therapy (HRT) consists of estrogen administered with or without progesterone. This administration of artificial estrogen to the body is the primary method doctors have used to treat and prevent osteoporosis.


osteoporosis chart

A meta-analysis that combines the results of many two-year estrogen replacement studies shows that bone density augmented seven percent in the spine, four percent in the neck and four point five percent in the forearm. Large studies have also shown a 20-35% reduction in hip fractures attributed to estrogen use, as well as reductions in fractures in many other places. These studies show that estrogen users receive some cushioning from osteoporosis and its related fractures. However, the authors of this study seek to know to what extent these estrogen users remain at risk for osteoporosis. The study also questions what effect these estrogen supplements will have on women as they approach advanced age, when they run the greatest risk for osteoporosis.

osteoporosis hrt

The study recruited women sixty-five years and older from communities all over the country between the years of 1986 and 1988. Almost a 1,000 White and African-American women were studied, although those who had already had suffered a hip fracture were disqualified. Although women currently taking estrogen lost less bone density than those who had never used estrogen or who had stopped using it, all groups lost bone density from the hip and calcaneus area.

According to this study, eight percent of women experienced osteoporosis bone loss while undergoing estrogen therapy. Estrogen was found to be of only limited effect in battling osteoporosis, although it was found to increase the mechanical strength of the proximal femur. The protective effects of estrogen depend on the age that a woman started taking it. Estrogen was helpful for premenopausal women for an average of 10 years, while for older women it was only helpful for no more than two to three years. We are left with the conclusion that while estrogen can help prevent osteoporosis, it by no means prevents it entirely.

Sources:
  • MD, MPH Nelson, Heidi D.; MA Rizzo, Joanne; PhD Harris, Emily; DrPH Cauley, Jane; MD, MPH Ensrud, Kristine; MD Bauer, Douglas C. and MD Orwoll, Eric. "Osteoporosis and Fractures in Postmenopausal Women Using Estrogen." (2002). Arch Intern Med.