Of 387 postmenopausal women who had bone scans between 2021 and 2025, 186 had low bone mineral density. The split between those on hormone therapy and those off it is what researchers presented Sunday at ENDO 2026, the Endocrine Society’s annual meeting in Chicago.
Among the 129 women using menopausal hormone therapy, 41 (31.8%) had low bone density. Among the 258 who did not, 145 (56.2%) did. After adjusting for major clinical risk factors, the team put the difference at a 69% lower risk of low bone density, defined as osteopenia or osteoporosis, in the spine and hip for women on therapy. Those are two places where fractures are common in older women.
The result held after accounting for age, time since menopause, vitamin D levels, smoking and other health conditions. Women on hormone therapy also had higher T-scores at the lumbar spine and total hip. The women’s mean age was 59.8 years.
“For years, many women have avoided menopausal hormone therapy because of safety concerns and warning labels,” said lead author Diego Espinoza-Peralta, vice president of the Mexican Society of Nutrition and Endocrinology. “This study revisits that narrative and shows that menopausal hormone therapy may have an important added benefit: protecting bone health. That shifts the conversation from ‘avoid if possible’ to ‘reconsider in the right patient.’”
Limits of the study
It was a retrospective cohort study, and the findings have not yet appeared in a peer-reviewed journal. The researchers did not have details of the specific types of hormone therapy used, or whether it was taken orally or through the skin. Espinoza-Peralta cautioned that, because the study was observational, the findings should be read as an association rather than proof of causality.
Outside doctors were measured. Dr. Paula Briggs of the University of Liverpool, immediate past chair of the British Menopause Society, welcomed the results but was not surprised. “Basically, this is not new,” she said, noting that the Women’s Health Initiative in 2002 showed a 34% reduction in hip fracture and a 30% reduction in overall fracture among hormone therapy users.
Dr. Ruthann Devera, an OB-GYN at MemorialCare Medical Group in Long Beach, California, who was not involved, said bone protection has long been a known benefit of the treatment. She also listed risks. Estradiol activates the uterine lining, so uterine cancer is a universal risk for women who still have their uterus, and some patients may face higher risk of heart attack, stroke and breast cancer. “The decision to start MHT needs to be individualized,” she said.
Anyone weighing hormone therapy should talk it over with their doctor.
Sources
- Hormone Therapy Cuts Low Bone Density Risk 69%
- Menopause: Hormone therapy linked to 69% lower risk of thinning bones
