Menopausal Estrogen Therapy and Hip Fractures

Abstract

The association between menopausal estrogen therapy and hip fracture was studied in a retirement community. Hip fracture cases (91) during a 5 yr period in female residents under age 80 yr were compared to age- and race-matched community controls. Estrogen use was recorded from the medical records of the outpatient care facility and personal interviews. The estimated risk ratio for use of oral estrogens in excess of 60 mo. was 0.42. This protective effect was limited to oophorectomized women for whom the risk ratio for a comparable duration of use was 0.14; the risk significantly decreased with increased duration but not with increased dosage. Diabetes mellitus, low Quetelet''s index, tallness, prolonged immobilization of physical inactivity, use of corticosteroids, early age at menopause, low levels of sunlight exposure and heavy cigarette smoking were each independent risk factors for hip fracture, but none confounded the observed association with estrogen use.