The role of hormone therapy in the treatment of osteoporosis

The concerns raised by the findings of the Women’s Health Initiative study resulted in many practitioners no longer considering the use of menopausal hormone therapy for the treatment of osteoporosis. Subsequent re-analyses of this study, recent publications on the use of lower doses and different modes of delivery of hormone therapy, and data suggesting that certain women will receive longer-term fracture prevention even with short-term use have resulted in a reappraisal of the use of oestrogen and oestrogen plus progestin therapy for the prevention and treatment of osteoporosis. These issues are discussed, and based on these more recent analyses it is suggested that menopausal hormone therapy could still be considered a first-line option for osteoporosis prevention and treatment in certain patients.