Breaking the Fall: Hormone Therapy’s Role in Preventing Fractures During Menopause – ARC Summit

Hormonal therapy has been conclusively shown to improve outcomes related to bone fractures, impacting both intermediate parameters and actual fracture incidents, including severe cases like hip fractures. Estrogen, in particular, significantly influences bone metabolism. Unlike many other interventions tested only in women already diagnosed with osteopenia or osteoporosis, hormonal replacement therapy (HRT) has been evaluated for its effects on bone health in women without selected fracture risks.

Significant trials such as the WHI and the PEPI trial have extensively studied HRT’s impact on bone health. The PEPI trial, for instance, enrolled hundreds of women over three years to compare several HRT regimens: conjugated estrogen (CE) alone, CE with medroxyprogesterone acetate (MPA) daily, CE with MPA sequentially, and CE with micronized progesterone.

These large-scale studies underscore the robust nature of research in this area, contrasting sharply with many smaller or less rigorous studies often seen in other areas of reproductive medicine, such as interventions for fibroids or endometriosis, which may not always be as well-supported by extensive data. This extensive research foundation significantly informs our understanding and application of HRT in preventing fractures among menopausal women.