Should postmenopausal hormone therapy be used to prevent osteoporosis?

OBJECTIVE

To discuss the risks and benefits of hormone therapy for the prevention of postmenopausal osteoporosis.

DATA SOURCES: A MEDLINE search was conducted to identify articles that are pertinent to the risks and benefits of hormone therapy for the prevention of postmenopausal osteoporosis. Additional references were obtained from the bibliographies of these articles.

STUDY SELECTION: Human studies that present efficacy and safety data for the effects of postmenopausal hormone therapy.

DATA EXTRACTION: Analysis of studies to determine the benefits of hormone therapy on bone (in terms of bone mineral density or fracture risk) and risks of hormone therapy in postmenopausal women.

DATA SYNTHESIS: Studies were analyzed to determine the risk-benefit profile of hormone therapy for the prevention of postmenopausal osteoporosis. This information was synthesized to help practitioners make decisions regarding the role of postmenopausal hormone therapy in the prevention of osteoporosis.

CONCLUSION

Given the risks of hormone therapy, some of which are associated with increased duration of use, hormone therapy cannot be routinely recommended for the sole purpose of preventing osteoporosis. Many alternative therapies exist that may offer patients a better benefit versus risk ratio.