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HRT: back to square one if treatment is halted
The definitive stopping of hormone replacement therapy during menopause (HRT) has its disadvantages. For instance the resumed loss of bone mass with a renewed risk of osteoporosis. However, there is one remedy.
The suspension in the United States of the Women’s Health Initiative study (WHI) after it turned out that HRT increased the risk of breast cancer and cardiovascular illnesses proved to be a disincentive for many women. This study cannot be transferred directly to the old continent, of course. Nevertheless, European women are quite rightly asking questions. There is also a consensus as regards not recommending systematic use of HRT, but basing the prescription of it on an individual approach.
Therefore the question whether stopping this treatment implies risks remains to be answered. The answer appears to be no in relation to cardiovascular problems and cancer. However, a study published in the US Archives of Internal Medicine confirms that stopping HRT results in a resumption of loss of bone mass. Brynne Ascott-Evans from Groote Schuur Hospital in Cape Town (South Africa) states that this phenomenon is significant from the third month following the time the treatment is stopped. And “twelve months later, the loss of bone mineral density (BMD) on lumbar vertebrae is 3.5%”.
The study whose results it reports has permitted a comparison of the results of two strategies applied to 144 menopausal women who stopped HRT. All the women were given daily doses of calcium and vitamin D to attempt to curb bone mass loss, supplemented by the administration to 95 of them of a non-hormonal medicine usually prescribed to counter osteoporosis, a bi-phosponate. It appears that in this case this drug permitted a “5.5% increase of BMD”.
These results, observed in relation to the spinal column (where fractures and compression of the vertebra that are typical of osteoporosis occur), were confirmed in other parts of the body, for instance in the hip. They thus confirm that the halting of HRT results in a return of the risk for bone mass, but support the WHO’s position adopted in Autumn 2002, and later by the entire scientific community, that there are other ways (apart from HRT) of preventing osteoporosis.
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