Common Questions
Does prior use of estrogen increase bone mineral density long term?
Estrogen's beneficial effects on bone density and fracture risk wane after the drug is stopped (1-3). Past use confers no lasting benefit and bone loss resumes following cessation. On average, BMD occurs at a rate of about 2.5 percent per year for the first 3 to 4 years after exposure to estrogen ceases (4,5). This is the same rate of loss that occurs around natural menopause.
Below are the rates of bone density loss after menopause with, without, and after estrogen use.
Image source: Ettinger B and Grady D. Maximizing the benefit of estrogen therapy for prevention of osteoporosis. Menopause 1994;1:19-24.
- Schneider DL, Barrett-Connor EL, and Morton DJ. Timing of postmenopausal estrogen for optimal bone mineral density. The Rancho Bernardo study. JAMA 1997; 277: 543-7.
- Michaelsson K, Baron JA, Farahmand BY, Johnell O, Magnusson C, Persson PG, Persson I, Ljunghall S on behalf of the Swedish Hip Fracture Study Group. Hormone replacement therapy and risk of hip fracture: Population based case-control study. BMJ 1998; 316: 1858-1863.
- Weiss NS, Ure CL, Ballard JH, Williams AR, Daling JR. Decreased risk of fractures of the hip and lower forearm with postmenopausal use of estrogen. N Engl J Med 1980; 303: 1195-1198.
- Lindsay R, MacLean A, Kraszewski A, Hart DM, Clark AC, Garwood J. Bone response to termination of oestrogen therapy. Lancet 1978; I(8078): 1325-7.
- Lindsay R, Aitken JM, Anderson JB, Hart DM, MacDonald EB, Clarke AC. Long-term prevention of postmenopausal osteoporosis by oestrogen. Lancet 1976; I(7968): 1038-41.
- Ettinger B and Grady D. Maximizing the benefit of estrogen therapy for prevention of osteoporosis.. Menopause 1994; 1: 19-24.