Trial reportThe Journal of clinical endocrinology and metabolism2017
No Increase in Fractures After Stopping Hormone Therapy: Results From the Women's Health Initiative.
Trial report in The Journal of clinical endocrinology and metabolism, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Antiosteoporosis therapy after discontinuation of menopausal hormone therapy: a systematic review.Hormones (Athens, Greece) · 2024Pooled it
- Association between age at menopause and fracture risk: a systematic review and meta-analysis.Endocrine · 2019Pooled it
- Preventing Hip (Proximal Femoral) Fractures: An Evidence-Based Review for Clinicians.Journal of clinical medicine · 2026Review
- Then and Now: What We Have Learned From the WHI.The Journal of clinical endocrinology and metabolism · 2026Review
- Discontinuation of menopausal hormone therapy and risk of fracture: nested case-control studies using routinely collected primary care data.The lancet. Healthy longevity · 2025Article
- Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis.Open life sciences · 2023Review
- The why and how of sequential and combination therapy in osteoporosis. A review of the current evidence.Archives of endocrinology and metabolism · 2022Review
- Pharmacological Therapies for Osteoporosis: A Bayesian Network Meta-Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Estrogen and bones after menopause: a reappraisal of data and future perspectives.Hormones (Athens, Greece) · 2021Review
- Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Review
- Lessons learned with Bone Health TeleECHO: making treatment decisions when guidelines conflict.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2019Review
- The Controversial History of Hormone Replacement Therapy.Medicina (Kaunas, Lithuania) · 2019Review
- The next step after anti-osteoporotic drug discontinuation: an up-to-date review of sequential treatment.Endocrine · 2019Review
- Patterns of menopausal hormone therapy use and hyperkyphosis in older women.Menopause (New York, N.Y.) · 2018Article
- Estrogen therapy for osteoporosis in the modern era.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 11 institutions in 1 country.
Funding
Abstract
Context: The Women's Health Initiative (WHI) hormone therapy (HT) trials showed protection against hip and total fractures, but a later observational report suggested loss of benefit and a rebound increased risk after cessation of HT. Objective: The purpose of this study was to examine fractures after discontinuation of HT. Design and Setting: Two placebo-controlled randomized trials served as the study setting. Patients: Study patients included WHI participants (N = 15,187) who continued active HT or placebo through the intervention period and who did not take HT in the postintervention period. Interventions: Trial interventions included conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) in naturally menopausal women and CEE alone in women with prior hysterectomy. Main Outcome Measures: Total fractures and hip fractures through 5 years after discontinuation of HT were recorded. Results: Hip fractures were infrequent (∼2.5 per 1000 person-years); this finding was similar between trials and in former HT and placebo groups. There was no difference in total fractures in the CEE + MPA trial for former HT vs former placebo users (28.9 per 1000 person-years and 29.9 per 1000 person-years, respectively; hazard ratio [HR], 0.97; 95% confidence interval [CI], 0.87 to 1.09; P = 0.63); however, in the CEE-alone trial, total fractures were higher in former placebo users (36.9 per 1000 person-years) compared with the former active group (31.1 per 1000 person-years), a finding that was suggestive of a residual benefit of CEE against total fractures (HR, 0.85; 95% CI, 0.73 to 0.98; P = 0.03). Conclusions: We found no evidence for increased fracture risk, either sustained or transient, for former HT users compared with former placebo users after stopping HT. There was residual benefit for total fractures in former HT users from the CEE-alone study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.