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KMID : 1007020080060010008
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Korean Soceity of Osteroporosis
2008 Volume.6 No. 1 p.8 ~ p.13
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Hormone Therapy and Osteoporosis
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Lee Hae-Hyeog
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Abstract
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During the perimenopause, both the quantity and quality of bone decline rapidly, resulting in a dramatic increase in the risk of fracture in postmenopausal women. Data from the large Women\’s Health Initiative (WHI), in which women with an intact uterus(mean age: 63 years) were randomly assigned to estrogen plus progestin, showed that HT increased total hip BMD and reduced the risk of fractures at the hip, vertebrae, and wrist. Similarly, the estrogen-alone component of the WHI, which involved women(mean age: 64 years) with prior hysterectomy, demonstrated a reduced rate of hip fracture. It is never too early in the menopause to evaluate women for bone loss and advise them on steps to take to prevent the declines in bone mass and quality that increase the risk of future osteoporosis and fracture. Postmenopausal women should therefore be screened for osteoporosis risk factors and have their BMD levels tested, if warranted, in accordance with current guidelines. Use of BMD assists physicians in diagnosing osteoporosis and in monitoring treatment effects. Low-dose hormone therapy and ultralow-dose hormone therapy can provide an effective protection against the postmenopausal decrease of BMD. Estrogen depletion after menopause become involved with postmenopausal bone loss, therefore ET(estrogen therapy) and EPT(estrogen-progestogen therapy) have been considered as first-line therapy for postmenopausal osteopenia and osteoporosis.
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KEYWORD
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Hormone-therapy (HT), Osteoporosis, Menopause, Women’s Health Initiative (WHI)
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