U.S. researchers report that menopausal hormone replacement therapy can raise bone density and lower the likelihood of fractures after menopause. The findings appeared in the peer‑reviewed journal Menopause and add to a growing body of evidence about how hormone treatment may influence skeletal health in aging populations across North America.
Osteoporosis is a condition characterized by thinning bone density, which leads to a higher risk of fractures, persistent pain, and potential disability. Before osteoporosis develops, many people experience osteopenia, a milder reduction in bone density. The risk of osteoporosis is linked in part to lower estrogen levels, a common occurrence after menopause. As a result, postmenopausal women generally face a higher fracture risk compared with men of the same age, a difference that underscores the importance of monitoring bone health in North American clinical practice.
The new study drew on data from more than 6,000 postmenopausal women and examined several hormone therapies. Researchers considered oral contraceptives, estrogen‑only pills, estrogen‑progestogen combinations, and estrogen‑only transdermal patches to represent a broad spectrum of treatment options commonly discussed with patients in Canada and the United States. This wide range allowed investigators to compare effects across different delivery methods and formulations that patients might encounter in routine care.
Findings showed that nearly all hormone therapies examined were associated with better bone mineral density readings in the lumbar spine when compared with no hormone treatment. Notably, the protection persisted even after therapy had ended, suggesting a lasting benefit for some patients that could influence long‑term decision making about osteoporosis prevention strategies in clinical settings and in patient education materials used by primary care providers and specialists alike.
Despite these gains in bone density, the study did not find a uniform reduction in osteoporosis prevalence across the sample. In other words, while hormones slowed the rate of bone loss and improved density in certain regions, they did not translate into a universally lower rate of osteoporotic fractures in every participant. This nuance highlights the need for personalized risk assessment, continued research, and careful consideration of potential risks and benefits when discussing hormone therapy with patients. Clinicians in North America may use these findings to guide conversations about bone health, particularly among postmenopausal women who are evaluating options to preserve mobility and reduce fracture risk over the long term, while staying mindful of individual health profiles and contraindications.