Do Benefits Exceed Risk?
Estrogen has not been shown to significantly reduce fractures in women who are 60 years old or over, according to the authors of the JAMA editorial. They say, “Since women in their 50s who do not have osteoporosis have a relatively low risk of fracture, the benefit of long-term treatment with estrogen to prevent bone loss and fractures may not exceed the risks.” According to Ettinger, a woman’s decision to take hormone replacement should not be based only on preventing osteoporosis, since there are other options. But more studies need to be done: The JAMA authors say no large trial has tested what effect estrogen may have on fracture risk in women who do have osteoporosis. “The debate surrounding the use of HRT underscores the need for a greatly expanded osteoporosis research effort, including definitive studies of HRT,” says National Osteoporosis Foundation director Sandra Raymond in a June 2001 news release. “Osteoporosis is an enormous public health problem, causing 1.5 million frac
