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June 13, 2001

Postmenopausal Hormone Therapy for Prevention of FracturesHow Good Is the Evidence?

JAMA. 2001;285(22):2909-2910. doi:10.1001/jama.285.22.2909

Estrogen has been used for many years to prevent bone loss and fractures in postmenopausal women. Support for this practice comes from 2 lines of evidence. First, observational studies consistently suggest that postmenopausal hormone therapy reduces the risk of hip and other types of fracture.1,2 However, observational studies are susceptible to selection bias and confounding. This may be especially true of studies of hormone therapy because users tend to be healthier, wealthier, and more active than nonusers.3 Even if observational studies are qualitatively correct, they may overestimate the degree of risk reduction attributed to hormone therapy.

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