Posted on 8 July 2022

Does HRT prevent osteoporosis?

While HRT is effective at slowing bone loss, it can raise a woman’s risk of serious conditions such as cancer and is rarely used as an osteoporosis treatment. Here’s what you need to know about the relationship between HRT, osteoporosis and stronger bones.

Hormone replacement therapy (HRT) is a lifeline for thousands of women experiencing menopause. Scientists have found that the therapy can have a significant impact on done health, with women receiving HRT showing a 5% increase in bone mass.

In this in-depth article, we explore the links between HRT and osteoporosis and explain what everyone can do to protect their bone health.

What is HRT?

During menopause, oestrogen levels in the body fall. HRT is a medicine that mimics oestrogen and progesterone in the body. It makes up for the loss women experience during the menopause.

“HRT is safe and effective when prescribed in the right way, for the right women,” says the Royal Osteoporosis Society ­­ but that’s not the end of the story.

HRT includes both oestrogen and progesterone because taking one without the other could increase your risk of developing womb cancer. (Women who have had a hysterectomy only need to take oestrogen.)

There are three types of HRT treatment:

  • Sequential combined therapy – you take oestrogen every day and progesterone for 12 days a month.
  • Continuous combined therapy – you take oestrogen and progesterone every day.
  • Oestrogen-only HRT – you take oestrogen every day

HRT treatment should be prescribed by your doctor. HRT is providing a lifeline for women across the world, helping them to cope with the symptoms of the menopause.

However, a shortage of HRT medication, including Oestrogel (Besins Healthcare), Ovestin cream (Aspen), and Premique Low Dose (Pfizer), is affecting thousands of women in the UK.

The HRT shortage is hitting the headlines and hurting women, with the then UK health secretary Sajid Javid holding meetings with suppliers to ease the flow.

Why is HRT good for bones?

HRT causes oestrogen levels to increase in the body, which can benefit bones. The increase in oestrogen can help in the bone-building and replacement process, reducing the risk of fractures in some women.

“Hormone replacement therapy (HRT) at different doses rapidly normalizes turnover, preserves bone mineral density (BMD) at all skeletal sites, leading to a significant reduction in vertebral and non-vertebral fractures,” say academics in a 2014 paper.

While HRT is typically used to help reduce the symptoms of the menopause, “osteoporosis prevention can actually be considered as a major additional benefit,” say scientists.

“HRT has also been shown to keep bones strong and reduce the risk of breaking a bone during treatment,” says the NHS.

Why isn’t HRT prescribed for osteoporosis?

NHS guidelines state that HRT shouldn’t be used to treat osteoporosis in women because it can lead to an increased risk of women developing certain conditions.

HRT slightly increases the risk of developing breast cancer, endometrial cancer, ovarian cancer, stroke, and venous thromboembolism.

The NHS says the risk of developing diseases is raised “more than it lowers the risk of osteoporosis.”

HRT treatment can also cause some side effects, including low mood and stomach cramps.

While HRT may not be prescribed specifically for osteoporosis, women on HRT are likely to experience some benefits for their bone health.

What are the links between osteoporosis and the menopause?

Women are at a much higher risk of developing osteoporosis than men, particularly as they age.

However, not every woman will develop osteoporosis. The higher your bone density before menopause, the less likely you are to develop osteoporosis.

According to the NHS, some women are more likely to develop osteoporosis than others.

Women are at greater risk of developing osteoporosis if they have:

  • early menopause (before the age of 45)
  • a hysterectomy before 45
  • absent periods for more than six months caused by dieting or exercise
  • If, for any reason, your bone mass isn’t great before menopause, you could be at greater risk of developing osteoporosis

You can learn more about whether menopause causes osteoporosis in our article here.

How can I improve bone health?

There are loads of things we can do every day to improve our bone health.

As well as boosting our bones, getting serious about our health can improve mood, mental health, and overall wellbeing.

The NHS says that everyone worried about developing osteoporosis should:

  • Eat a healthy diet
  • Get regular exercise
  • Cut down on drinking and stop smoking
  • Taking a daily supplement containing 10 micrograms of vitamin D

You should speak to your doctor if you have any questions or concerns about your bone health. They can provide information, advice, and guidance on how best to manage the menopause and lower your risk of developing osteoporosis.

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