At one point in time, not so long ago Hormone Replacement Therapy or HRT was the standard for not only treating menopausal symptoms but also preventing osteoporosis. HRT is a combination of estrogen and progestin, a synthetic form of progesterone. Hormones naturally found in the body. At the time of menopause however the levels fluctuate causing a myriad of symptoms.
Osteoporosis most often affects postmenopausal women and it is believed to be due to the drop in estrogen. Osteoporosis is a condition in which the bones lose too much density and become weak. Osteoporosis itself is not usually a problem; it is the fractures that come along with the disease.
Because the bones become thinner they are more susceptible to breaks. These fractures often occur from minimal trauma. A slight fall or injury, or even just bending over to lift something can cause a break. Fractures most often occur in the hip, spine and wrist but can happen anywhere in the body that bone has been affected.
The Role of Hormones
It has long since been known that hormones play a vital role in bone development and maintenance. Bone is a living tissue, which is constantly being broken down, or removed and renewed or replaced. Osteoporosis occurs when the amount of tissue being replaced does not keep up with what has been removed.
Over time, the bone gradually becomes less dense. Estrogen helps to control the balance between the breakdown and renewal.
As the level of estrogen falls the breakdown of bone speeds up while the renewal is slowed leading to a larger amount of bone mass being lost. There has been controversy over using hormone replacement for years since early on too much estrogen alone was linked to endometrial cancer.
To eliminate this risk, progestin was prescribed in combination with the estrogen. A few years ago a clinical study was conducted called the Womens Health Initiative to test the effects of HRT. While initial testing showed a marked improvement in bone health, and a reduced risk of hip fracture, the study was discontinued after a few years due to a minimal percentage of participants getting breast cancer.
It was determined that due to the risks posed that HRT should not be considered as a prevention or treatment option for osteoporosis in premenopausal women, or women who do not have symptoms of menopause. These risks include heart attack, stroke, and an increased risk of breast cancer.
For those at high risk of getting osteoporosis HRT could still be considered since it has shown to reduce the risk of fracture. Anyone taking or thinking of taking HRT should just be aware of the risks and have a knowledgeable medical professional explain to them the benefit and risks and to make an informed decision as to whether or not the benefits outweigh the risks. HRT is also commonly used in conjunction with other treatments for osteoporosis. It can be taken in pill form or administered transdermally in patch form. Common side effects include headache, breast tenderness, and vaginal bleeding.
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