- People going through menopause often experience a range of symptoms such as hot flashes, sleep disturbances, mood changes, brain fog, and osteoporosis.
- Hormone therapy can help alleviate these symptoms, but some people are reluctant to take it because past studies have suggested it may increase the risk of endometrial, breast, and ovarian cancer.
- Now, a study has added to the evidence that hormone therapy can improve bone density, helping to prevent bone fractures.
- The researchers found that women taking menopausal hormone therapy had a 69% lower risk of low bone mineral density than those not using hormone replacement.
Some people sail through menopause, the end of a woman’s reproductive years, with the cessation of menstrual periods being the only sign that it has happened. For others, the years leading up to and following menopause are a time of hot flashes, disturbed nights, urinary problems, thinning hair, mood changes, brain fog, and a loss of bone density, which can lead to osteoporosis.
Menopausal hormone therapy (MHT) can help to alleviate these symptoms, but it is not suitable for everyone going through the menopause.
Now, a small study being presented at ENDO 2026, the Endocrine Society’s annual meeting in Chicago, is adding to the evidence that menopausal hormone therapy (MHT) can help prevent bone density loss that often leads to fractures.
In their study, researchers found that women on MHT were 69% less likely to have low bone mineral density than women who were not on the treatment.
“We’ve known that bone protection is a benefit of menopause hormone treatment and this study supports that long-held belief.”
— Ruthann Devera, M.D., OBGYN at MemorialCare Medical Group, Long Beach, California, who was not involved in the study
The findings of the study are yet to be published in a peer-reviewed journal.
The researchers carried out a retrospective cohort study of 387 postmenopausal women who had undergone DEXA bone scans between 2021 and 2025 to assess bone mineral density (BMD). All scans were carried out by the same certified bone densitometry technician and analyzed by the same clinical densitometrist to minimize inter-operative variability.
Of the cohort, 129 used menopausal hormone therapy, and 258 did not. There were no significant differences in age, vitamin D levels, and years since menopause between the 2 groups.
Lead and corresponding author, Diego Espinoza-Peralta, MD, MSc, Endocrinologist, Clinical Trialist, Centro Médico Dr. Ignacio Chávez ISSSTESON / Mexican Society of Nutrition and Endocrinology (SMNE) Hermosillo, Sonora, Mexico, told Medical News Today that the women, who had a mean age of 59.8 years, “included women receiving menopausal hormone therapy in routine practice, including different regimens according to individual clinical indications.”
The researchers did not have details of the individual types of hormone therapy, or whether it was by oral or transdermal administration.
From the scans, the researchers identified low bone mineral density in almost half of the women (186 individuals), but it was nearly twice as common in those not using MHT, as Espinoza-Peralta outlined: “Among the women receiving MHT, 41 of 129 (31.8%) had low BMD, compared with 145 of 258 (56.2%) among non-users.”
MHT users had significantly higher BMD than non-users in both the lumbar spine and hip — two areas in which fractures are common in older women.
“I believe our findings are clinically relevant because they provide real-world evidence supporting the association between menopausal hormone therapy (MHT) and better skeletal health in postmenopausal women. In our cohort, women receiving MHT had significantly lower prevalence of low bone mineral density, higher lumbar spine and total hip T-scores, and a 69% lower adjusted odds of low bone mineral density after accounting for major clinical risk factors.”
— Diego Espinoza-Peralta
Dr Paula Briggs, Associate Clinical Professor, University of Liverpool and immediate past chair of the British Menopause Society, who was not involved in the study, welcomed the findings, but was not surprised by them:
“Basically, this is not new — even the controversial Women’s Health Initiative from 2002 highlighted a 34% reduction in hip fracture and an overall fracture reduction of 30% in hormone therapy users.”
“Hormone therapy prevents bone loss, which can lead to osteoporosis and an increase in the risk of fractures, which can have a significant impact on quality of life,” she added.
“One aspect that I find particularly interesting is the consistency of the association across multiple measures of skeletal health,” Espinoza-Peralta told MNT. “Women receiving MHT not only had lower prevalence of osteopenia and osteoporosis but also demonstrated significantly higher continuous T-scores at both the lumbar spine and total hip.”
And this is only one potential benefit of MHT, as Devera explained:
“In addition to reducing the risk of osteoporosis, another major benefit of MHT is relief of menopause symptoms. Menopause can be a challenging time for many women due to the vast array of physiologic[al] changes. These include hot flashes, brain fog, insomnia, irritability, anxiety, and body aches to name a few. These changes can often be disruptive to a woman’s well-being; thus, MHT offers an effective treatment option.”
Hormone therapy may also have some risks
However, she highlighted that there were some risks, which people should consider before deciding whether to opt for MHT:
“Estradiol activates the uterine lining; thus, uterine cancer is a universal risk of estradiol treatment in women who have their uterus. Certain patients may also be at higher risk for heart attack, stroke, and breast cancer. These risks can vary depending on a patient’s medical history and age.”
She advised: “The decision to start MHT needs to be individualized. Although MHT offers many benefits, it’s not a safe treatment option for every woman. Also, each woman should have a clear idea of what her treatment goals are. This will allow her and her physician to make the best choice moving forward.”
And Espinoza-Peralta cautioned: “Because this was an observational study, the findings should be interpreted as an association rather than proof of causality.”
“Nevertheless,” he added, “they support the concept that MHT may represent an important and potentially underutilized strategy for preserving bone health in appropriately selected postmenopausal women.”
