Menopausal Hormone Therapy & the Management of Postmenopausal Osteoporosis

Over the past couple of decades, the potential benefits of menopausal hormone therapy (MHT) on bone health have been increasingly recognized. This review, published in "Osteoporosis International" in 2020, looks over the most recent studies and provides guidance on MHT for bone health.

MHT is a type of therapy that uses specific hormones to help alleviate the symptoms of menopause, including hot flashes, night sweats, and sleep disturbance.

So what does this have to do with bone health? Estrogen, one of the hormones used in MHT and one of the hormones that declines during menopause, is known to affect the cells that build up and break down bones. During menopause there is a rapid decline of bone mass density (BMD). After menopause, bone mass density declines at a steady pace. Because of this, doctors and researchers believe that MHT might help alleviate some of the bone loss that happens during menopause.

This review concluded that MHT could provide potential benefits to bone health and bone mass density, but that not enough is known right now. Of all of the studies reviewed in this article, several showed that women had fewer fractures and higher bone mass density during and after MHT, while other studies didn't show the same effects.

It is important to note that MHT is also known to have a number of potential side effects, including cardiovascular events, thromboembolic disease (blood clots), stroke and breast cancer. Each of these side effects depended on a number of factors including the specific hormones used in therapy and how and at what age the therapy was administered.

Overall this review concluded that MHT has the potential to provide benefits for bone health, but benefits should be weighed against the potential risks. Outside of MHT, there are other ways to increase bone mass density that do not have as many negative side effects: exercise is one. Talk to your doctor to figure out what is best for you.