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HRT, or estrogen/progesterone, is commonly used to relieve the symptoms of
menopause. However, because estrogen plays such an important role in maintaining
bone, HRT is another option to consider to prevent and treat osteoporosis,
especially if you are also seeking relief from other symptoms of menopause.
How does HRT work?
Following menopause, the body produces much less of the sex hormones estrogen
and progesterone, resulting in a loss of bone density. Estrogen/progesterone
treatment is not intended to "replace" the loss of these hormones, but to
supplement these hormones to the lowest level required to prevent bone loss.
Treatment can consist of estrogen alone or estrogen and progesterone in
combination.
How effective is it?
Estrogen/progesterone treatment increases bone density and prevents spine and
hip fractures.
Who can take it?
Estrogen/progesterone is used to prevent osteoporosis in postmenopausal
women, including women who have experienced menopause before age 45 (early
menopause.) Estrogen/progesterone is used to treat osteoporosis in
postmenopausal women.
How is it taken?
A dose of 0.625 mg of oral conjugated equine estrogen (or its equivalent) is
taken each day. Unless you have had a hysterectomy, progesterone is also taken
to reduce the risk of developing uterine cancer. Estrogen/progesterone are
available in both pill and patch form and in a variety of regimens.
Are there side effects?
Side effects can include depression, headaches, breast tenderness,
premenstrual syndrome, skin irritation and weight gain. Menstrual bleeding may
also occur. Experimenting with doses, types (pills, patches) and regimens may
help to eliminate (or minimize) these side effects.
There is an increased risk for breast cancer, stroke and cardiovascular
disease in women who take estrogen/progesterone for more than five years. Women
using estrogen/progesterone are encouraged to establish regular cardiovascular
and breast health monitoring programs with their doctor. There is also an
increased risk of venous thromboembolism (blood clots), similar to that for
women using raloxifene. The risk of endometrial cancer is increased if estrogen
is used without progesterone; however, this risk is minimized by the addition of
progesterone for women with an intact uterus.
The substantial risks for cardiovascular disease, stroke and invasive breast
cancer may lead to an unfavorable risk/benefit ratio with prolonged use of HRT
when taken only for the treatment of postmenopausal osteoporosis. Other options
for treatment should be explored first.
Learn more about Drug Treatments:
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