Hormone Therapy to Treat Osteoporosis
Weighing the Pros and Cons

If you and your doctor are considering hormone therapy (HT) to treat osteoporosis, you will want to weigh the benefits against the potential risks. Learning as much as you can about HT, and discussing HT and other treatment options with your health-care professionals will help you make an informed decision.

Benefits

Prevention and Treatment of Osteoporosis
For women with osteoporosis, hormone therapy

• slows the rate of bone loss
• helps the body absorb calcium from the gut (bowel)
• reduces the amount of calcium lost in urine
• decreases the risk of hip fractures due to osteoporosis

Beside its role in preventing and treating osteoporosis, HT can also have other benefits for menopausal and post-menopausal women.

Other Benefits
HT can relieve moderate to severe menopausal symptoms, including:

• hot flashes
• night sweats
• insomnia
• mood swings
• vaginal dryness
• bladder incontinence

The Society of Obstetricians and Gynaecologists advises that HT is a safe and effective option for the treatment of moderate to severe menopausal symptoms when taken for up to five years.

Several studies have also shown that the use of HT may reduce the incidence of colon cancer.

Side Effects and Risks

Side Effects
Temporary side effects of HT can include:

• breast swelling and tenderness
• bloating
• headaches
• mood changes

These side effects usually occur in the first three to six months of therapy, then decrease over time. Changing the dose, HT schedule or products used may reduce these side effects.

HT can also cause you to have your period or experience spotting, depending on the nature of the HT prescribed. If your doctor prescribes estrogen to be taken every day with progesterone, for 10 to 14 days per month, you will have monthly periods. If you are prescribed estrogen and progesterone (at a low dose) to be taken every day, you will not have a monthly period but you may experience light bleeding (or spotting) during the first year. Speak to your doctor about these HT options and possible bleeding patterns.

Risk of Blood Clots
HT may increase your risk of blood clots, although this is a rare side effect.

Risk of Breast Cancer
Some studies have shown a small increase in risk in women who have taken HT for five years or more. However, many other factors may contribute to the risk of breast cancer (for example, alcohol use, lack of exercise, late menopause, weight gain after menopause) to a greater degree than long-term estrogen use.

Risk of Heart Disease
At one time, it was believed that HT might lower a woman's risk of having a heart attack or stroke. We now know that HT does not protect women from cardiovascular disease and should not be recommended for the sole purpose of preventing heart disease. Studies show that it may slightly increase your risk of blood clots, heart attack and stroke.

Who Should Not Take HT
You should NOT use HT if are pregnant or if you have a history of blood clots, stroke, heart disease, liver disease or breast cancer.

Making a Decision

If you are considering taking HT to treat osteoporosis, discuss all of the benefits and risks with your doctor before starting any therapy.

If you are postmenopausal, you should also have routine mammograms, physical and pelvic exams, to monitor your health.

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