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Experts Weigh in on Hormone Therapy

Risks & Benefits of Postmenopausal Use of Hormones

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VOLUME 2, ISSUE 8
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Osteoporosis


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The table below summarizes the available evidence on the risks and benefits of hormone therapy. Included are all randomized trials and meta-analyses looking at disease incidence or mortality. Inclusion of observational trials was dependent on size: case-control studies with 500 or more cases of the disease and cohort studies with at least 2,000 women are included here.

The year noted is when the study results were published. The name following the title of the study is the last name of the first author on the publication.

E = estrogen; P = progestin

Year

Study

Study Type

Participants

Hormones

Results

Other Notes

1987

Framingham Heart Study, Kiel

Cohort

2,873

E

Ever-use reduces hip fractures 35%; use within 2 years reduced hip fractures 66%

Majority of women used estrogen

1990

Naessen

Cohort

23,246

E, E+ P

21% reduction in hip fractures

No distinction between E and E + P

1999

Hoidrup

Cohort

6,159

E, E + P

Reduction in hip fractures, but not statistically significant

Greater effect seen with E + P than E alone

1999

Grodstein (A)

Cohort

9,236

E, E + P

35% reduction in hip fractures with E alone; 36% reduction with E + P

 

2001

Torgerson

Meta-analysis of randomized trials

22 studies including 8,774 women

E, E + P

27% reduction in non-vertebral fractures

Greater effect (35% reduction) among women beginning hormone use before age 60; No distinction made between E vs. E + P

2002

Women's Health Initiative

Randomized

16,608

E + P

33% reduction in hip fractures;

24% reduction in total fractures

Average follow-up 5.2 years


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