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Hormone Replacement and Osteoporosis Conclusion

In October 2004, the United States Surgeon General issued the first-ever report on bone health. The report warned that by 2020, half of all American citizens older than 50 years will be at risk for fractures from osteoporosis and low bone mass if no immediate action is taken by individuals at risk, doctors, health systems, and policy makers. HRT and ERT are one option women should consider in their plan for preventing osteoporosis.

The estrogen in both HRT and ERT is the ingredient that helps strengthen the bones. The body gradually stops producing estrogen during menopause, which leads to bone loss and possibly osteoporosis and broken bones (fractures). By taking estrogen, a woman can slow bone loss and even regain bone density because estrogen works with the body's bone-building cells to stimulate bone formation and slow the process of bone loss.

The risks of HRT sound scary, but keep in mind that a woman's annual individual risk is still relatively small. Also, these studies focus on the long-term risks and benefits and not the short-term risks and benefits of taking hormones, such as osteoporosis prevention. If a woman has been taking HRT or ERT, she should talk to the doctor about her relative risks and treatment goals.

Doctors should prescribe any estrogen therapy for osteoporosis only for the shortest period of time possible. ERT and HRT used to prevent osteoporosis after menopause should only be considered for women at significant risk of developing osteoporosis, and nonestrogen medications should be carefully considered (see Treatment of Osteoporosis and Understanding Osteoporosis Medications for more information).