HRT risks raise threat from osteoporosis

Related tags Bone loss Osteoporosis Estrogen

The rapid decline in the use of HRT, along with a general lack of
nationalised screening programmes and an ageing population, may
lead to a significant increase in the prevalence of osteoporosis,
according to a new report.

Osteoporosis currently affects 30 million people (predominantly women) worldwide and if left untreated, can be fatal.

Historically hormone replacement therapy (HRT) has been used to boost oestrogen levels in women and to prevent, among other things, the bone loss that leads to osteoporosis.

But last year's findings from the Women's Health Initiative study - showing that HRT increased the risk of heart attack, stroke, breast cancer and blood clots - has led to a dramatic reduction in its use. This could leave thousands of women unprotected from the increased risks of bone loss and fractures associated with menopause, according to Datamonitor women's health analyst Victoria Williams.

"Coupled with the general bone loss that occurs after the age of 35, the lowered oestrogen levels in women after the menopause may cause loss of bone mass at a rate that is two to four times faster than that seen before the menopause, leading to osteoporosis, or porous bones,"​ explained Williams.

New awareness of the risks of HRT have already caused a surge in use of natural alternatives to counter menopause symptoms. But they are also likely to prompt increased demand for preventative measures against osteoporosis, namely an adequate intake of calcium and vitamin D.

Datamonitor's report, aimed at the pharmaceuticals industry, predicts that the osteoporosis market will grow from $8.3 billion in 2003 to $14.7 billion by 2014, driven by uplift after the WHI and new product launches to 2009.

But it also confirms that the best defence against the disease is building strong bones, particularly before the age of 30.

"One of the greatest unmet needs in this area remains primary prevention and the need for adequate testing programmes to identify those at risk, initiate treatment and prevent costly fractures later in life,"​ concludes Williams.

Foods fortified with calcium and vitamin D are growing - at a compound annual rate of 7.6 per cent according to Datamonitor - but manufacturers and public healthy agencies may need to do more to promote them. The bone health category, worth £60 million in the UK in 2002, remains siginificantly smaller than others like gut health, at an estimated value of £111.2 million at the same time.

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