Women who have gone through menopause are at increased risk for bone loss because they no longer benefit from the protective effects of the estrogen their bodies once produced naturally. We used to think that hormone replacement therapy protects postmenopausal women against heart disease and stroke. We now know that it doesn't; in fact, it increases that risk (see page 182). What can women now take to prevent bone loss?
The drug Evista (raloxifene) is a selective estrogen receptor modulator widely used to prevent and treat osteoporosis. Although it's neither estrogen nor a hormone, it has some estrogen-like properties, the most important of which is its ability to reduce bone loss and increase bone density (thus preventing and/or minimizing osteoporosis). It does not adversely affect the breast and uterus the way estrogen does, so it does not cause cancer of those organs, tenderness of the breast, or vaginal bleeding. On the other hand it does not relieve symptoms of menopause, such as hot flashes, either.
Here's What's New
Data from a 4-year study of almost 8,000 postmenopausal women showed that a subset of about 1,000 women with one or more risk factors for cardiovascular disease who were taking Evista to control osteoporosis had a 40 percent lower risk of developing heart disease and a 62 percent reduction in the risk of all fatal and nonfatal strokes. (They also enjoyed a 70 percent decline in the incidence of breast cancer.)
The Bottom Line
Evista does appear to exert a beneficial effect on heart disease, stroke, and breast cancer. It has few adverse effects other than a small increased risk of clot formation in the veins. For that reason, anyone with varicose veins or a history of thrombophlebitis should not use it, nor should those who are premenopausal or pregnant. However, in my opinion, virtually every postmenopausal woman at risk for osteoporosis -- especially those also vulnerable to heart disease, stroke, and breast cancer -- should be taking it.
(Reprinted from Dr. Isadore Rosenfeld's Breakthrough Health 2004: 157 Up-to-the-Minute Medical Discoveries, Treatments, and Cures That Can Save Your Life, from America's Most Trusted Doctor! by Isadore Rosenfeld, M.D. (Rodale Inc., Paperback, $14.95/$21.95CAN; 1-57954-900-4). Permission granted by Rodale, Emmaus, PA 18098. Available wherever books are sold.)
Copyright © 2004 Isadore Rosenfeld, M.D.
About the Author - Dr. Isadore Rosenfeld's legions of fans follow his regular column in Parade magazine and his popular Sunday-morning television series Sunday Housecall on FOX News Channel. In addition to his numerous scientific publications and medical textbooks for doctors, he has written nine New York Times bestsellers. He is a distinguished member of the faculty at New York-Presbyterian Hospital/Weill Medical College of Cornell University and attending physician at New York Presbyterian Hospital and Memorial Sloan-Kettering Cancer Center.