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Hormone Replacement and Osteoporosis

Hormone Replacement and Osteoporosis Introduction

Hormones are produced by glands in our bodies. They are chemicals that have specific effects on different parts of our bodies. For example, the ovaries produce estrogen that enters the bloodstream and has effects on the uterus. As we age, our bodies start to produce smaller amounts of hormones, particularly reproductive hormones such as estrogen and progesterone in women and testosterone in men.

Eventually, production of reproductive hormones declines, and in women, the decline results in menopause, when menstruation stops. In women, bone loss occurs rapidly in the perimenopausal years. Bone loss can eventually lead to osteoporosis (or porous bones). Without prevention or treatment, osteoporosis can progress without pain or symptoms until a bone breaks (fractures). Fractures commonly occur in the hip, spine, and wrist. Osteoporosis is the underlying cause of more than 1.5 million fractures annually (300,000 hip fractures, approximately 700,000 vertebral fractures, 250,000 wrist fractures, and more than 300,000 fractures in other areas). The estimated national cost (hospitals and nursing homes) for osteoporosis and related injuries is $14 billion each year in the United States.

Osteoporosis is a major public health threat for 44 million Americans, 68% of whom are women. In the United States today, 10 million people already have osteoporosis and 34 million more have low bone mass (weak or thin bones); these people are at increased risk for fractures and osteoporosis. Half of women and a quarter of men older than 50 years will have an osteoporosis-related fracture in their lifetime.

Osteoporosis is also a global problem. Worldwide, one third of women aged 60-70 years and two thirds of women 80 years or older are estimated to have osteoporosis; a total of 200 million women are thought to be affected. In several European countries, women older than 45 years spend more time in the hospital for osteoporosis-related problems than for any other disease. In the next 50 years, the number of hip fractures for both men and women will more than double. According to the World Health Organization (WHO), osteoporosis is the second leading healthcare problem after cardiovascular disease. In France, Germany, Italy, the United States, the United Kingdom, Spain, and Japan less than half of women with osteoporosis are diagnosed.

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