NEW YORK, Nov 18 (Reuters Health) -- Women who smoke, drink alcohol, or
lead a sedentary life have the most to gain from hormone replacement therapy
with estrogen or estrogen-progestogen combinations -- at least in terms of a
lower risk of hip fractures, Danish researchers report.
Overall, women who were currently on hormone therapy had a 30% lower risk
of hip fracture than women who were not using hormones, the investigators
calculated in a study of more than 6,000 postmenopausal women.
But further analysis showed that the protective effect of hormones was
limited to certain groups of women, according to Dr. Susanne Hoidrup, from
Copenhagen University Hospital in Denmark, and colleagues.
Smokers and ex-smokers had a lower risk of hip fracture if they used
hormones than if they did not. In contrast, women who had never smoked had about
the same risk of hip fracture whether or not they were on hormone therapy. A
similar relationship held for alcohol consumption. Women who drank one or more
alcoholic drinks per week had a lower risk of hip fracture if they used hormone
therapy, but abstainers had about the same risk whether or not they used
hormones.
Physical activity levels also affected the benefits of hormone therapy.
"Sedentary women experienced a high degree of fracture protection," the authors
note in the November 15th issue of the American Journal of Epidemiology. The
amount of protection "leveled off with increasing physical activity."
When women and their doctors discuss long-term hormone replacement
therapy, they should consider how much the woman smokes, drinks, and exercises,
Hoidrup's team concludes. For some women, protection against hip fracture may be
a reason to decide to start taking hormones.
