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Menopause hormone therapy improves bone structure, study finds

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Hormone therapy for menopausal symptoms can improve bone structure as well as bone mass, helping to prevent osteoporosis, according to new research published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.
Previous studies have revealed the positive impact of menopausal hormone therapy (MHT) on bone mineral density, but the new study is the first to show that MHT can also improve bone mass and structure, and that these benefits persist for at least two years after women stop treatment.

“When used in the right context, specifically in postmenopausal women younger than 60 years old for whom the benefits outweigh risks, menopausal hormonal therapy is effective for both the prevention and treatment of osteoporosis,” explained the study’s first author, Dr Georgios Papadakis, of Lausanne University Hospital in Switzerland.

The researchers recruited 1,279 women aged 50 to 80, of whom 22% were undergoing MHT during the study, 30% were past users and 48% had never used MHT.

Dual x-ray absorptiometry (DXA) scans of the participants’ lumbar spine, femoral neck and hip were used to assess bone mineral density. Based on the scan results, the women were assigned a Trabecular Bone Score assessing the quality of their underlying bone structure. This score can be used to predict fracture risk in postmenopausal women.

The results showed higher Trabecular Bone Scores in current MHT users compared to past users or women who had never used MHT, the Endocrine Society reported. All bone mass density values were significantly higher in current users compared to past users or participants who had never used MHT.

The researchers also found that past users of the therapy had higher bone mass density and a trend for higher bone microarchitecture values compared to women who had never used MHT. The duration of MHT had no effect on bone health.

“Women at menopause should take note of this study, because its results can help optimise the use of menopausal hormone treatment in women at risk of osteoporosis,” Dr Papadakis said.