Fracture Risk Increases After Women Stop Hormone Therapy: Study Finds - Video

A new study published in The Lancet Healthy Longevity has found that the bone fracture protection provided by menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT), disappears within a year of stopping treatment. The study also revealed that many women experience an elevated fracture risk in the years following discontinuation, compared to those who have never used menopausal hormone therapy before; risk levels eventually drop below those of never-users.

During menopause, women experience a natural decline in hormone levels, particularly oestrogen, which not only causes symptoms like hot flashes and mood changes, but also leads to weakened bones. menopausal hormone therapy is known to reduce fracture risk by supplementing oestrogen levels, but due to potential risks like breast cancer and blood clots, long-term use is generally discouraged. Until now, the long-term effects on fracture risk after stopping MHT had remained unclear and inconsistently reported.

To address this gap, researchers analyzed data from six million women across 2,000 general practice surgeries in the UK. They identified women with first fracture records and matched them with similar women without fractures, comparing their histories of menopausal hormone therapy use. The study tracked outcomes for up to 25 years, making it one of the most comprehensive investigations to date.

Lead author Dr Yana Vinogradova said, “For most women, the bone protective effect of menopausal hormone therapy use disappears completely within about one year of treatment being stopped, then their fracture risk rises compared to never users, peaking after about three years, before declining to become again equivalent to never users – about 10 years after discontinuation – and then again continuing to decline relative to never users. So, even after stopping menopausal hormone therapy, women should benefit from notably reduced fracture risk in their later decades.”

“These novel findings may also usefully stimulate further clinical and biological research into these treatments,” adds Dr Vinogradova.

Reference: Discontinuation of menopausal hormone therapy and risk of fracture: nested case–control studies using routinely collected primary care data, Vinogradova, Yana et al. The Lancet Healthy Longevity, Volume 0, Issue 0, 100729