Hormone replacement as the first-line prevention for postmenopausal osteoporosis

Abstract

For more than two decades, HRT was the treatment of choice for the prevention of postmenopausal osteoporosis. HRT is known to be efficacious in preventing postmenopausal bone loss and fractures that occur as a result of postmenopausal estrogen deficiency. Nevertheless, with the publication of the results from the Women’s Health Initiative (WHI) in 2002, the world’s largest randomized placebo-controlled study of HRT in seemingly healthy, yet elderly, women, the political climate surrounding HRT use in postmenopausal women in general changed suddenly and dramatically. The WHI results indicated a lack of prevention of cardiovascular disease (CVD) in this population, and reported a small but significantly increased risk of CVD among women in the HRT arm, which was in clear contrast to the results from the abundant animal and large epidemiological studies. The WHI study has been criticized regarding the study population and HRT regimen used. Very recent reanalysis of the WHI data suggested that HRT in early me...