Women's Health Initiative Trial
While randomized controlled studies and meta-analyses have demonstrated the effect of hormone therapy on BMD,^51-53 the Women's Health Initiative (WHI) confirmed for the first time the effects of combined continuous hormone therapy on osteoporotic fracture reduction at several sites, including the hip.^54,55 Hip and vertebral fractures decreased by at least one-third in both of the trials and total fractures decreased by 24%-30%. The clear fracture benefits of postmenopausal hormone therapy (HT) are offset by the adverse effects (e.g., increased risk of stroke, cognitive impairment, and deep vein thrombosis) encountered in the women taking HT.^55-58 The WHI trials also found that HT provided no cardioprotective benefit, and increased the risk of breast cancer.