For years, women have been told that taking hormone replacement therapy (HRT) 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