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Feature Article

Postmenopausal osteoporosis: is there a role for menopausal hormone therapy?

Andrea Fernandes, Christina Jang, Emma Duncan

Figures

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© ERICKSONSTOCK/STOCK.ADOBE.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY

Abstract

Menopausal hormone therapy (MHT) increases bone density and prevents fracture. However, the publication and accompanying media coverage of the Women’s Health Initiative study made many women fearful of MHT and many doctors reluctant to prescribe it. There is increasing recognition that MHT does have a place in health management of postmenopausal women, including for fracture prevention.

Key Points

  • Oestrogen-alone and combined oestrogen–progestogen therapy increase bone mineral density and reduce vertebral and nonvertebral fractures in postmenopausal women.
  • Use of menopausal hormone therapy (MHT) in general, and for osteoporosis specifically, has been controversial since the early closure of the Women’s Health Initiative (WHI) study.
  • In the final analysis of the WHI study, the benefits of MHT were found to be considerable and, particularly for younger women, may outweigh the risk of harm.
  • Commencing MHT is a valid option for postmenopausal women under the age of 60 years and within 10 years of menopause, with no specific contraindications, not only for vasomotor symptoms but also for bone protection.

Figures

© ERICKSONSTOCK/STOCK.ADOBE.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY
© ERICKSONSTOCK/STOCK.ADOBE.COM MODELS USED FOR ILLUSTRATIVE PURPOSES ONLY