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HRT Update: Therapy May Reduce Fractures, Boost Some Risks
Date:5/29/2012

By Kathleen Doheny
HealthDay Reporter

MONDAY, May 28 (HealthDay News) -- Updated evidence on hormone replacement therapy for menopausal women presents good news for those at risk of osteoporosis, but a mixed bag of results regarding breast cancer and other chronic diseases.

While estrogen-only and estrogen-plus-progestin formulations reduce the risk of fractures, both increase the odds for stroke and other conditions including gallbladder disease, according to a new update of available evidence compiled for the U.S. Preventive Services Task Force, an independent expert panel that is revising its guidelines.

Estrogen-plus-progestin therapy raises the risk of breast cancer and probable dementia, while estrogen alone reduces the risk of breast cancer, the researchers found.

"We looked at all the published studies on hormone therapy for the prevention of chronic disease," said Dr. Heidi Nelson, who led the update. "What is new here is, we've taken all the results from the last 10 years and tried to distill them into the latest, most current results and how they might apply to individuals."

Some protective effects found in earlier research now appear weaker, added Nelson, a professor of medical informatics, clinical epidemiology and medicine at the Oregon Health & Science University, in Portland. Similarly, some risks look even stronger.

The findings are published online May 29 in the Annals of Internal Medicine.

Years ago, hormone therapy was often prescribed to prevent chronic conditions such as osteoporosis and cardiovascular disease. But initial results of the Women's Health Initiative study, published in 2002, found harmful effects for estrogen-plus-progestin regimens. Two years later, serious alarms were raised about estrogen-only therapy.

As a result, the task force recommended against both types of treatment for prevention of chronic disease.

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