Menopausal Hormone Therapy Linked to Better Bone Health in Postmenopausal Women: Study

The findings were presented at ENDO 2026 by Diego Espinoza, a clinical researcher affiliated with INMEDS and SMNE, Hermosillo, Mexico.

Declining estrogen levels after menopause accelerate bone loss and increase the risk of osteopenia and osteoporosis. Although menopausal hormone therapy (MHT) is known to support bone health, concerns related to earlier regulatory warnings have limited its use. Recent updates to these warnings have renewed interest in evaluating their benefits for bone preservation.

To assess this association, researchers conducted a retrospective cohort study of 387 postmenopausal women who underwent DXA scans between 2021 and 2025. Among them, 129 women used MHT and 258 did not. Bone health was classified according to World Health Organization criteria, and factors associated with low bone mineral density were analyzed.

Key findings from the study include:

• Low bone mineral density was identified in 48.1% of the overall study population.
• Women receiving menopausal hormone therapy had significantly higher lumbar spine BMD than non-users (mean T-score: −0.62 vs −1.02).
• Total hip BMD was also significantly higher among hormone therapy users (mean T-score: −0.32 vs −0.81).
• The prevalence of low BMD was substantially lower among women using MHT (31.8%) compared with non-users (56.2%).
• After adjusting for age, years since menopause, body mass index, vitamin D levels, smoking status, and metabolic conditions, MHT use was associated with a 69% reduction in the odds of low BMD.
• Longer time since menopause was linked to a higher risk of low BMD, with risk increasing by approximately 9% for each additional year.
• Smoking more than doubled the likelihood of low BMD.
• Higher vitamin D levels were associated with a lower risk of reduced bone density.

The researchers concluded that menopausal hormone therapy was independently associated with higher bone mineral density and substantially lower odds of osteopenia or osteoporosis in postmenopausal women. The findings suggest that, beyond its established role in managing menopausal symptoms, MHT may offer significant benefits for bone preservation when used in appropriately selected women.

The authors noted that hormone therapy could represent an underused strategy for protecting skeletal health, particularly during the early years after menopause, when interventions may have the greatest impact on preventing future bone loss and fracture risk.

Reference:

ORF34-05 - Menopausal Hormone Therapy Is Associated with a 69% Lower Risk of Low Bone Mineral Density in Postmenopausal Women: A Retrospective Cohort Study