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publicado em 25/07/2011 às 11h00:00
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Women who discontinued hormone therapy is most at risk of hip fracture

Women who discontinued treatment had lower bone mineral density and a 55% higher risk of fractures

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The study, led by professor of pediatrics and preventive medicine and the orthopedic Roksana Karim Richard M. Dell, followed more than 80 000 women aged 60 years or more in California.

Women taking hormone therapy in June 2002 were followed until December 2008 to obtain data on continuation or discontinuation of treatment.

A longitudinal observational study determined that women who stopped hormone therapy had a 55% higher risk of hip fractures and lower bone mineral density. The increased risk early, two years after women stop therapy.

Karim said the results of this study should encourage women and doctors to reconsider the benefits of such treatment on bone health.

"If we look at recent research, there are rare cardiovascular benefits and risks, particularly in women who recently entered menopause. Maybe it's time to rethink guidelines on hormone therapy for women with a high risk of hip fracture," said Karim.

The study also found that women taking bisphosphonates (Fosamax, for example) after stopping hormone therapy saw little benefit from these drugs.

"We have known for a long time that women not taking hormones after menopause are at a greatly increased risk of suffering a bone fracture than women who take hormones. This new study shows very well that when hormone therapy is stopped, the risk of hip fracture rises substantially, "said the professor of preventive medicine at Howard N. Hodis.

According to the Centers for Disease Control and Prevention, one in five hip fracture patients die within one year after it happened. Recent data also show an increase of 55% risk of stroke within a year after the trauma.

The study was limited by lack of data on the period in which women have hormone therapy before 2002. Complete data on how many women had suffered previous fractures - an indication of increased risk - also were not available before 2002.

Women should consult their doctors to determine if they are at high risk of bone loss and take the test to check bone density, and perform a review of family histórco fractures.

Previous studies have shown conclusively that women who took hormone therapy had a substantial reduction in bone loss compared to women taking a placebo.

"Hormone therapy is the only therapy that has shown to reduce bone fractures in a population of women who were not selected to be at high risk for bone fracture. This population represents the typical menopausal woman," Hodis said.

Hodis noted that women may consider individualized hormone therapy. For example, recent data showed that the reduction in risk of breast cancer observed after seven years of estrogen therapy was reduced in women who were followed for an additional period of five years.

   Palavras-chave:   Hormone therapy    Estrogen    Hip fracture    Fracture of the femoral neck    Bone health   
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