Menopausal hormone therapy may improve bone health

Women who undergo menopausal hormone therapy for symptoms such as hot flashes may not only have increased bone mass but also improved bone structure, a new study has claimed.

It is the first study to show that the bone health benefits persist for at least two years after women stops the treatment, researchers said.

"When used in the right context, specifically in postmenopausal women younger than 60 years old for whom the benefits outweigh risks, menopausal hormonal therapy is effective for both the prevention and treatment of osteoporosis," said Georgios Papadakis, from Lausanne University Hospital in Switzerland.

Osteoporosis is a progressive condition in which bones become structurally weak and are more likely to fracture or break. Menopause, which usually occurs when a woman is in her 40s or 50s, significantly speeds bone loss.

Over time, the human body is constantly breaking down and building new bone tissue. The imbalance between bone breakdown and formation causes bone mass to decrease, so osteoporosis can develop and fractures can occur more easily.

The cross-sectional study is based on data from the OsteoLaus cohort which consisted of 1,279 women ages 50 to 80 residing in the city of Lausanne, in Switzerland.

The participants were divided into three categories: 22 per cent were undergoing menopausal hormone therapy (MHT) during the study, 30 per cent were past users and 48 per cent of women had never used MHT.

To measure whether MHT influenced bone health, researchers used dual X-ray absorptiometry (DXA) scans of the participant's lumbar spine, femoral neck and hip to assess bone mineral density.

Based on the scan results, the women were assigned a Trabecular Bone Score assessing the quality of their underlying bone structure.

This score can be used to predict fracture risk in postmenopausal women.

Age and body mass index were major factors used in the study. Other variables included the history of fractures in participants, and the use of supplements such as current or past use of calcium and/or vitamin D.

Blood test results for vitamin D levels from 1,204 out of the 1,279 participants were also factored into the study.

The researchers found higher Trabecular Bone Scores in current MHT users compared to past users or women who had never used MHT.

All bone mass density values were significantly higher in current users compared to past users or participants who had never used MHT.

Past users of the therapy exhibited higher bone mass density and a trend for higher bone microarchitecture values compared to women who had never used MHT. The researchers note that the duration of MHT had no effect on bone health.

The study appears in the Journal of Clinical Endocrinology and Metabolism.

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