Menopause increases your risk for developing osteoporosis because your body's natural production of the hormone estrogen declines. Estrogen helps keep bones strong. However, new studies have shown that postmenopausal hormone therapy, available as a combination of estrogen and progestin (a synthetic form of the hormone progesterone) or estrogen therapy alone, poses serious health risks. While these same studies also showed conclusively that postmenopausal hormone therapy helps prevent fracture risk, researchers concluded that this benefit outweighed the increased risk for breast cancer, heart attack, stroke and blood clots.
In January 2003, the U.S. Food and Drug Administration (FDA) announced that it would require a new, highlighted and boxed warning on all estrogen products for use by postmenopausal women. The so-called "black box" is the strongest step the FDA can take to warn consumers of potential risks from a medication.
The "black-box" warning also advises health care professionals to prescribe estrogen products at the lowest dose and for the shortest possible length of time. Women taking estrogen products are cautioned to have yearly breast exams, perform monthly breast self-exams and receive periodic mammograms.
New, lower-dose versions of the hormone therapies used to treat symptoms of menopause are currently being developed. The FDA recently approved a low-dose version of the combination estrogen-progestin treatment sold as Prempro, which is expected to be available in the summer of 2003.