Menopausal hormone therapy linked to better bone health

Clinical Takeaway: Bone health may be an important consideration when discussing menopausal hormone therapy with appropriate candidates. In addition to relieving vasomotor symptoms, hormone therapy may help preserve bone mineral density and reduce future fracture risk.

Low bone mineral density is a major contributor to fractures, disability, and loss of independence in older women. Although menopausal hormone therapy is recognized as an option for preventing bone loss, concerns about safety have led many women to avoid treatment.

Researchers evaluated 387 postmenopausal women who underwent dual-energy x-ray absorptiometry (DXA) scanning between 2021 and 2025 to assess the relationship between menopausal hormone therapy use and bone mineral density.

Women using menopausal hormone therapy had an approximately 69% lower risk of low bone mineral density, defined as osteopenia or osteoporosis, in the spine and hip compared with nonusers. The association remained significant after accounting for age, years since menopause, vitamin D levels, smoking, and other health conditions.

The findings suggest that the skeletal benefits of hormone therapy may extend beyond symptom relief and could play an important role in long-term health decisions for some women. The results may be particularly relevant for women in early menopause who are considering treatment for bothersome symptoms and are also concerned about future fracture risk.

“For years, many women have avoided menopausal hormone therapy because of safety concerns and warning labels. This study revisits that narrative and shows that menopausal hormone therapy may have an important added benefit: protecting bone health,” said principal investigator Diego Espinoza-Peralta, MD, MSc. “That shifts the conversation from ‘avoid if possible’ to ‘reconsider in the right patient.’”

Source: Espinoza-Peralta D, et al. Endocrine Society Annual Meeting, Abstract ORF34-05. 2026 June 14. Menopausal hormone therapy reduces risk of low bone mineral density by 69%