Q&A

No long-term benefit shown for bones after HRT

J Fam Pract. 2004 June;53(6):442-450
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  • CLINICAL QUESTION: Does hormone therapy continue to provide protection from hip fractures after the treatment is stopped?
  • STUDY DESIGN: Cohort (prospective)
  • SETTING: Population-based
  • SYNOPSIS: The National Osteoporosis Risk Assessment (NORA) study began in 1997 as a longitudinal observational study of postmenopausal women aged >50 years at study entry. It includes 140,584 women, of whom 48% were taking HRT at study entry and an additional 14% had used postmenopausal estrogen in the past. Ninety-two percent of the women were white. A total of 53,737 women never used HRT, 8723 quit taking it within the last 5 years, and 10,151 quit more than 5 years ago. The rest of the women were currently using HRT.
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BOTTOM LINE

Women taking short-term hormone replacement therapy (HRT) for symptom relief cannot expect long-term bone protection. Hip fracture risk is at least as great for women who stop postmenopausal hormone therapy as that for women who have never used it. The loss of protection occurs within 5 years of cessation of treatment. (LOE=1b)

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