Hormone therapy and bone mineral density

Hormone therapy and bone mineral density | Image Credit: © WavebreakmediaMicro - © WavebreakmediaMicro - stock.adobe.com.

Hormone therapy can increase lumbar spine bone mineral density (BMD) and prevent bone loss in postmenopausal women, according to a recent study published in Menopause, the journal of the North American Menopause Society (NAMS).

Increased focus has been given to bone health and the reduction of fractures for continued mobility in an aging population. Osteoporosis is a debilitating condition, affecting about 14 million individuals in the United States. It is more commonly seen in postmenopausal women than men, as it is often associated with a deficiency in estrogen.

Osteoporosis leads to lower BMD and may cause pain, fractures, and disability because of bone fragility. While hormone therapy (HT) such as estrogen-only and estrogen-progestogen combinations has been used to prevent and manage osteoporosis, studies have shown conflicting evidence on long-lasting benefits following hormone discontinuation.

To determine types of hormone preparations associated with BMD, postmenopausal bone loss, and postmenopausal osteoporosis, investigators conducted a study using data on over 6000 postmenopausal women. Data was collected from the national Health and Nutrition Examination Survey.

Investigators also examined the effects of HT withdrawal. Therapies investigated included estrogen-only patches, oral contraceptive pills, estrogen-only pills, and estrogen-progestogen combination pills.

An increase in lumbar spine BMD in postmenopausal women was seen from all therapies examined. Protection against postmenopausal bone loss was also found in all therapies except estrogen-only patches, with benefits remaining even after HT discontinuation. However, HT was not associated with changes in osteoporosis prevalence.

“This large cross-sectional study showed that current and prior use of multiple types of hormone therapies, including combined hormone contraception used in premenopausal women and menopause hormone therapies, were linked with bone protection in postmenopausal women and that these effects persisted after discontinuation of treatment,” said Stephanie Faubion, MD, MBA, NAMS medical director.

Faubion also recommended further research on how time since stopping HT and varying doses impact bone health, including fracture risk.

Reference

Hormone therapy increases lumbar spine bone mineral density, protects against bone loss. EurekAlert. May 8, 2023. Accessed May 9, 2023. https://www.eurekalert.org/news-releases/988518#:~:text=A%20new%20study%20suggests%20that,after%20hormones%20have%20been%20discontinued