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Adding Vitamin D and calcium to HRT reduces fracture risk

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Although controversy still exists, many women are on hormone replacement therapy (HRT). In addition to combatting menopausal symptoms such as hot flashes and vaginal dryness, HRT promotes grown risk; thus, reducing the risk of hip fractures from osteoporosis. A new large study has found that adding Vitamin D and calcium to HRT further reduces the risk of fractures among postmenopausal women. The findings were published in the February 2012 edition of the journal Menopause.

The objective of the study was to determine whether adding Vitamin D to HRT would reduce the risk of hip fractures in postmenopausal women. For the study, postmenopausal women, aged 50 to 79, who were enrolled in the Women’s Health Initiative were evaluate. The study group comprised of women from 40 US facilities with an average follow-up of 7.2 years. A total of 27,347 women were randomly assigned to receive either HRT alone (0.625 mg of conjugated estrogens (Premarin) alone) or 0.625 mg of conjugated estrogens plus 2.5 mg of medroxyprogesterone acetate daily). A total of 36,282 women were randomly assigned to receive 1,000 mg of calcium plus 400 IU of Vitamin D daily; each of these women were compared to a woman who received a placebo. The main outcome measurements were hip fractures and measured bone mineral density.

The researchers found that the preventive value of calcium plus Vitamin D therapy was highest among women who also received HRT. They found that calcium plus Vitamin
D supplementation at any level reduced the risk of fracture.

The authors concluded that postmenopausal women at normal risk for hip fracture who are on calcium plus Vitamin D supplementation had a significantly reduced risk of hip fractures, compared to women on HRT alone.

Although the exact medical cause for osteoporosis is unknown, a number of factors contribute to osteoporosis, including the following:

  • Aging: Bones become less dense and weaker with age.
  • Race: Caucasian and Asian women are most at risk; however, all races may develop the disease.
  • Body weight: Obesity is associated with a higher bone mass; therefore, individuals who weigh less and have less muscle are more at risk for developing osteoporosis.
  • Lifestyle factors: The following lifestyle factors may increase a person's risk of osteoporosis:
    • Physical inactivity
    • Caffeine
    • Excessive alcohol use
    • Smoking
    • Dietary calcium and Vitamin D deficiency
    • Certain medications
    • Family history of bone disease

Take home message:

This study notes that if you are on HRT, adding calcium and Vitamin D may reduce your fracture risk. Calcium and Vitamin D may also benefit bone health among women not on HRT.