For years, women have been told that taking hormone replacement therapy (HRT) during menopause may help reduce the risk of fractures, despite the fact that scientific evidence of this was lacking. However, according to a new review of 22 previous studies on the subject, HRT does NOT benefit bones.

In an analysis of trials in which postmenopausal women received HRT, British researchers found that across the studies, HRT cut fracture risk by 27%. But many of the trials were of questionable quality and most were not designed to gauge fracture risk, making them less-than-ideal measures of HRT's effectiveness, according to some experts.

After menopause, women are at increased risk of the bone-thinning disease osteoporosis and its related fractures. Many doctors believe that replacing the estrogen lost through menopause will cut the risk of bone breaks. However, this belief is based on research showing HRT might prevent bone loss.

But there is NO solid evidence on fracture reduction.

The researchers showed NO significant benefit for older women, the age group most at risk of fractures.

However there was some benefit in women who started the estrogen younger than 50.

All of these questions await the results of an ongoing US trial of HRT's effects on fracture risk and heart health -- another area where studies have yielded conflicting results. The study of 27,500 women randomly assigned to take HRT for 9 years should be complete in 2005.

There was a time when doctors were so sure of HRT's positive effects on the heart, that they believed the therapy's benefits must outweigh the risks for most women.

JAMA June 13, 2001;285:2891-2897, 2909-2910

Dr. Mercola's Comments:

First of all, I want to mention that this study does highlight one possible benefit of estrogen. If a woman has her ovaries surgically removed then she will likely benefit from being placed on estrogen. I do believe that is why a benefit was found in the younger women in this meta analysis. If a woman still has her ovaries then there is likely very little benefit to being placed on estrogen and there is, indeed, great potential risk. The only other option where I feel estrogen is warranted short term would be for the treatment of hot flashes that fail to respond to therapeutic doses of black cohosh which is an effective herbal phytoestrogen frequently used for this condition. It is interesting to note that both the study authors and the editorialists have received funding from or served as consultants to several drug companies that market HRT or other osteoporosis treatments including bisphosphates. So let's examine what is going on here. Could it be that the number one drug in America, Premarin, is being downplayed so a greater market share can be created for a new drug, Fosamax? That would not surprise me, and I have certainly seen far worse conflicts of interests in medicine. If you are not aware of the lack of benefit and harm that Fosamax can cause, please review the links below which also discuss some natural alternatives to increase bone density. Related Articles: Estrogen No Cure For Bone Loss Fosamax May Damage Liver Does Fosamax (Aldrenoate) Prevent Bone Loss? Two New Studies Say It Does, I Say Beware! <