Decreased Risk of Fractures of the Hip and Lower Forearm with Postmenopausal Use of Estrogen

TLDR

The study aimed to assess estrogen use among women aged 50–74 who had sustained hip or lower forearm fractures. We interviewed 327 such women and compared their estrogen use with a random sample of 567 age‑matched women from the same region. Women who used estrogen for six years or more had a 50–60 % lower fracture risk (RR 0.3–0.6), whereas shorter use offered little benefit, and the protective effect was evident only in current users at daily doses of 0.625 or 1.25 mg, supporting long‑term estrogen use as a fracture‑risk reduction strategy.

Abstract

We interviewed 327 women who had been 50 to 74 years of age when treated for fracture of the hip or lower forearm, to determine their use (or lack of use) of estrogen preparations. Their responses were compared with those in a random sample of 567 women who were of similar age and from the same region. The risk of fracture was 50 to 60 per cent lower in women who had used these drugs for six years or longer than in women who had not used them (95 per cent confidence interval of relative risk, 0.3 to 0.6); those using them for shorter periods received less benefit, if any. A decreased risk of fracture was clearly evident only in women still taking estrogens and evident at either common daily dose (0.625 and 1.25 mg). In conjunction with the finding that estrogens can retard the development of osteoporosis in postmenopausal women, our data argue that lowering of the risk of hip and forearm fractures must be weighed as a benefit of long-term estrogen use. (N Engl J Med. 1980; 303:1195–8.)