Ending hormone replacement therapy leads to rapid bone loss in elderly women.

2002 DEC 26 - (NewsRx.com & NewsRx.net) -- Ending hormone therapy treatments may cause a decrease in bone mineral density in elderly women, according to a new study published in The Journal of Clinical Endocrinology & Metabolism.

Two other related studies published in the same journal also demonstrate the effects of recombinant human growth hormone (HGH) treatment in osteoporotic men and oral dehydroepiandrosterone (DHEA) in treating young women with osteoporosis.

In July, researchers announced the ending of one portion of the Women's Health Initiative (WHI) study due to evidence that questioned the safety and effectiveness of the estrogen plus progestin treatment in postmenopausal women. Now, researchers led by J.C. Gallagher at Creighton University have revealed that elderly women who stop taking hormone therapy experience significant losses in their bone mineral density (BMD). These losses in BMD could lead to severe osteoporosis and fractures.

In a double-blind, randomized, placebo-controlled trial, these researchers had previously studied the effects of three different treatments - estrogen therapy or estrogen plus progestin therapy in women with a uterus; calcitriol alone; and a combination of calcitriol plus estrogen or estrogen plus progestin therapy in nearly 500 women ages 65-77 years for 3 years. The women in all three groups experienced increases in BMD during the treatments. A 2-year follow-up study evaluated how discontinuation of the therapy affected the BMD, bone markers and calcium absorption and serum parathyroid hormone (PTH) levels in the women.

Researchers found that after discontinuing the treatments for 2 years, women in all three treatment groups experienced rapid bone loss and a majority of the loss occurred during the first year following treatment. Additionally, increases in calcium absorption and decreases in serum PTH levels also reversed after the treatments were stopped.

"The recent hormone therapy findings in the WHI trial have caused many women to discontinue their treatments. However, until now we did not know how ending the hormone therapy would effect bone health," said Christopher Gallagher, lead investigator on the study. "Our study demonstrates the critical need for these women to work with their doctors to monitor their bone health and to consider carefully the disadvantages of discontinuing hormone therapy and to also find alternative treatments to maintain their bone mineral density if they decide to discontinue the therapy."

Osteoporosis is a silent disease that is responsible for more than 1.5 million hip fractures annually worldwide. Most fractures occur in postmenopausal women, however, the disorder also affects more than two million men. Furthermore, approximately one third of all osteoporotic fractures occur in men. Few studies have been conducted to examine the effects of human growth hormone (HGH) on osteoporosis patients. Now, a study published in the November issue of JCEM shows that HGH treatments can improve bone mineral density (BMD) in men with idiopathic osteoporosis (i.e., men without any demonstrated hormonal, nutritional, or other risk factors for diminished bone density).