NEW YORK (Reuters Health) Mar 25 - Postmenopausal women who stop hormone replacement therapy (HRT) do not loose bone at an unusually high rate, researchers report in the Archives of Internal Medicine for March 25. The authors also report that HRT does not appear to promote additional bone mineral density (BMD) after that seen in 3 years of therapy.
Dr. Gail A. Greendale, from the University of California at Los Angeles School of Medicine, and colleagues collected data on 495 women who participated in the 3-year Postmenopausal Estrogen/Progestin Interventions randomized controlled trial (PEPI-RCT). These women underwent additional BMD measurements as part of the PEPI Safety Follow-up Study.

Among women who stopped HRT after 1 year in PEPI-RCT, during the subsequent 2 years they had annual BMD changes of -0.54% at the hip and -0.81% at the spine. Women who discontinued HRT after the 3 years had yearly BMD changes of -1.01% at the hip and -1.04% at the spine, Dr. Greendale's team found.

Compared with women in PEPI-RCT who did not receive HRT, BMD loss among women receiving HRT was not significantly different whether they discontinued HRT during or after PEPI-RCT, they note.

"Women who continued HRT after the PEPI-RCT did not show additional BMD gains," the investigators report. They conclude that "HRT for approximately 7 years did not provide further BMD benefit beyond that accrued at 3 years. Stopping HRT did not lead to an accelerated rate of BMD decline."

Dr. Greendale and colleagues add that the findings "argue against accelerated bone loss as an explanation for the lack of hip fracture protection afforded by HRT use. From a clinical perspective, our results suggest that women who stop HRT may resume bone loss, but that it will not be at a very rapid rate."

Arch Intern Med 2002;162:665-672.

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