The study making these claims for HRT came from a retrospective review of patients’ records (reduced funding required; no patients directly involved; scope for selecting favourable statistics and ignoring the unfavourable; unbalanced opposing groups). Of these there were 2,700 patients on HRT, 8,100 not, and this has a significant potential for many other unmeasured factors to influence the figures.
Could this be the sort of study where the purpose is to find a significant alternative market for a genre of drugs with falling sales? I would first want to know who funded this project; could it just possibly be a manufacturer of HRT?
Even if we accept the figures at face value, with 150,000 patients requiring replacement knees or hips in the UK annually, and 2% of the total requiring a second operation within 3 years, then 150,000 patients would require HRT (for females) or biphosphonates (for males) to reduce the number of second operations in that time-frame from 3000 to 1500. But there is no information as to whether the recurrence is removed or merely postponed to a later year.
Other factors to consider are that the apparent risks of HRT (breast and other hormone-dependent cancers, heart attacks and strokes) are highest in just the age range most vulnerable to hip fracture.
The role of bioidentical progesterone and osteoporosis
And also, most importantly, yet again there is a failure to consider the use of bioidentical progesterone as a viable alternative. HRT is often quoted as being beneficial for osteoporosis, but the oestrogen content is limited to slowing down the breakdown of old bone; as HRT contains no progesterone, only synthetic progestins, no new bone is being made and the bone remaining is becoming older and more brittle.
We know that progesterone encourages osteoblasts to rebuild bone; and reduce inflammation which, with the addition of a quality bone support supplement to provide all the building blocks and co-factors needed, is likely to be a safer, more permanent and a much more effective way of tackling the problem.
Further reading on osteoporosis:
What Your Doctor May Not Tell You About Osteoporosis – a book by John Lee, MD