Study finds stopping HRT leads to a period of higher risk of bone fracture for most women
A recent study conducted by experts from the School of Medicine at the University of Nottingham has shed light on the effects of stopping menopausal hormone therapy (MHT), also known as Hormone Replacement Therapy (HRT), on bone fracture risk in women. The study, published in Lancet Healthy Longevity, revealed that the protective effect against bone fractures that women experience while on MHT diminishes within a year of discontinuing the treatment.
Menopause triggers a decrease in hormone levels, particularly estrogen, leading to various physical and mental symptoms that may require the use of MHT. However, estrogen deficiency in women also contributes to age-related bone weakening. Previous research has shown that MHT can reduce the risk of fractures during treatment due to its protective role in bone health.
Despite the benefits of MHT in preventing fractures, long-term use is associated with an increased risk of breast cancer and blood clots. Therefore, it is crucial for women using MHT to understand the duration and persistence of the protective effects on bone health after discontinuation of the treatment. Past studies have provided conflicting and limited information on this aspect, focusing only on the initial years after stopping MHT.
In this new study, researchers analyzed data from 6 million women across 2,000 GP surgeries in the UK to track fracture risk over a span of 25 years. By comparing MHT use in women who experienced fractures with matched controls, the study found a clear pattern of increased fracture risk after stopping MHT. The bone protective effect of MHT disappeared within a year of discontinuation, leading to a temporary elevation in fracture risk compared to women who had never used MHT. This risk peaked around three years post-discontinuation before gradually declining to levels comparable to non-users.
Dr. Yana Vinogradova, the lead author of the study, emphasized the importance of understanding how fracture risk changes after stopping MHT. The observed risk pattern was consistent across all types of menopausal hormonal treatments, with the level of excess risk varying based on treatment type and duration of MHT use. These findings can guide healthcare providers and patients in making informed decisions about MHT treatment options and anticipating potential periods of increased fracture risk.
The study’s results underscore the need for ongoing research to further explore the effects of MHT on bone health and inform clinical practice. By providing valuable insights into the long-term implications of MHT use, this study aims to improve the management of menopausal symptoms and reduce the risk of fractures in women undergoing hormone therapy.
