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HT for menopausal symptoms benefits bone health
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Trabecular bone score assessment reveals that hormone therapy for menopause symptoms is associated with preservation of bone microarchitecture, and the effect persists on trabecular bone score and bone mineral density for at least 2 years after withdrawal.
“It is clearer than ever that estrogen-containing hormonal replacement therapy after menopause is effective for both the prevention and the treatment of osteoporosis,” Georgios Papadakis, MD, of the service of endocrinology, diabetes and metabolism at Lausanne University Hospital in Switzerland, told Endocrine Today. “Given that this treatment cannot be lifelong due to risk of adverse effects with rising age, this study can help clinicians handle the follow-up of women after treatment withdrawal. No excessive bone loss seems to take place after treatment cessation in our study, even though heterogeneity between subjects is possible.”
Papadakis and colleagues evaluated data from the OsteoLaus study on 1,279 women to determine the effect of menopausal HT on trabecular bone score (TBS) and bone mineral density before and after withdrawal. DXA was used to assess spine TBS and BMD at the lumbar spine, femoral neck and total hip.
Participants were divided into groups based on HT use: current users (n = 282), past users (n = 380) and never users (n = 617).
Compared with never users and past users, current users had consistently higher values for TBS and BMD at all sites in adjusted and unadjusted models. Compared with never users, past users had higher lumber spine BMD (P = .017) and total hip BMD (P = .026) after adjustment for age and BMI.
Decreases in all-sites BMD and TBS were observed in adjusted slopes for 10-year increments with smaller decreases in the current users compared with never users and past users (P < .05 for trend).
In current and past users, no relationship was found between menopausal HT duration and bone outcomes. In past users, when time since HT discontinuation was less than 2 years compared with more than 5 years, all BMD and TBS values were significantly higher.
“This study illustrates for the first time that hormonal treatment after menopause improves not only bone mass but bone structure as well,” Papadakis told Endocrine Today. “We also showed that the benefits persist for at least 2 years after cessation of hormonal treatment. We aim to further explore indirect effects of estrogen that may be contributing to bone benefits, particularly changes in muscles and fat mass. By a longitudinal follow-up of the women of OsteoLaus cohort, we plan to better distinguish between women with strong residual effect after hormone cessation and those at risk of important bone loss, for which other treatments should be promptly introduced.” – by Amber Cox
For more information:
Georgios Papadakis , MD, can be reached at Georgios.papadakis@chuv.ch.
Disclosure: Papadakis reports no relevant financial disclosures.
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