Osteoporosis is a progressive disease in which bones become weaker and more likely to break. New research suggests hormone therapy may improve bone health in women at risk of the disease.
Normally, the human body breaks down and absorbs bone tissue, but it creates new bone tissue to make up for the loss.
Throughout the first half of one’s life, there is a balance between the amount of bone lost and the amount gained. But after menopause, women lose bone mass at a much higher rate, with more bone being broken down than is formed.
As menopause usually takes place between the age of 40-50, 2 in 3 women over the age of 50 will experience osteoporotic fractures.
Men are also affected, as they, too, lose bone mass faster with older age. The International Osteoporosis Foundation report that 1 in 5 men men over 50 will have an osteoporosis-induced fracture.
In women, estrogen helps protect bone, so decreased levels of the hormone during and after menopause may be responsible for osteoporosis. Similarly, lower levels of testosterone in men may also contribute to the disease.
The benefits of menopausal hormone therapy (MHT) on bone density have been documented before. Studies have shown there is a dose-response of estrogen therapy for bone protection, with even low doses of MHT preserving and improving bone density.
But a new study – conducted by researchers from the Lausanne University Hospital in Switzerland – investigates for the first time whether MHT can also improve bone mass and structure.
They collected data from the OsteoLaus cohort, which comprised of 1,279 women living in Lausanne, aged between 50-80 years.
Researchers divided participants into three categories: 22 percent underwent MHT during the study, 30 percent had benefited from MHT before the treatment, and 48 percent had never had MHT.
Scientists used dual X-ray absorptiometry (DXA) scans of the patients’ lumbar spine, femoral neck, and hip to evaluate bone mineral density. Based on the scans, the women were given a Trabecular Bone Score, which measured the quality of their bone structure. The Trabecular Bone Score is normally used to predict fracture risk in postmenopausal women.
The main variables considered in the study were age and body mass index (BMI). The study also adjusted for the patients’ history of fractures, as well as supplement intakes, such as calcium and vitamin D.
The results were published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.
The study has shown for the first time that MHT improves bone mass and structure.
Results also indicated that bone health benefits induced by MHT persist for at least 2 years after women cease the 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.”
Lead author Dr. Georgios Papadakis
Researchers found higher Trabecular Bone Scores in patients undergoing MHT at the time of the study, compared with past users of the therapy and participants who had never used MHT.
The bone mass density values were all significantly higher in current users. Previous users of the therapy showed higher bone mass density and higher bone microarchitecture, compared with patients who had never used MHT.
The duration of the menopausal hormone treatment did not affect bone health.
“Women at menopause should take note of this study because its results can help optimize the use of menopausal hormone treatment in women at risk of osteoporosis,” Papadakis concludes.