HRT Halt May Temporarily Raise Fracture Risk
New Study Reveals Nuance in Post-Hormone Bone Health
Women discontinuing menopausal hormone replacement therapy (HRT) face a significant, albeit temporary, increase in fracture risk. This finding emerges from extensive new data, which also indicates a beneficial long-term effect on bone density for these individuals compared to those who never used HRT.
Understanding the Transition
A major analysis of millions of women’s health records, published in *The Lancet*, highlights a critical period after stopping HRT. Certified menopause specialist Dr. Deborah Kwolek emphasized the need for proactive bone health management during this phase.
“It’s reassuring that long term, you didn’t seem to be worse off if you had taken hormones in the past. And it reconfirms that when you first go off the hormones, you’re going to lose some benefit, which can translate into higher fracture risk and that needs attention.”
—Dr. Deborah Kwolek, Assistant Professor at Harvard Medical School
Dr. Kwolek, who also leads the Mass General Women’s Health and Sex and Gender Medicine Program, called the findings a crucial reminder to prioritize bone health for women entering and navigating menopause.
Extensive Data Analysis
Researchers, spearheaded by Dr. Yana Vinogradova from the University of Nottingham, meticulously examined the records of over 648,000 women aged 40 and older. They compared these individuals to nearly 2.4 million women without fracture histories. The study tracked fracture risks for up to 25 years after hormone therapy cessation, considering estrogen and progestogen combinations.
Long-Term Benefits Emerge
The study’s authors noted that even after discontinuing HRT, women could experience substantially reduced fracture risk in older age. This positive outcome was observed even for those who used HRT for shorter durations, possibly due to concerns like breast cancer history.
These findings present a contrast to some previous research, such as the Women’s Health Initiative post-trial study, which did not identify an elevated fracture risk after HRT cessation. Estrogen is well-established as vital for bone health, particularly during the menopausal transition, by preventing bone loss.
Tailoring Care to Individual Risk
Dr. Kwolek stressed the importance of assessing a woman’s baseline fracture risk. For younger, healthier individuals, a minor increase in risk upon stopping HRT may be less concerning. However, for an older woman with existing osteoporosis, the impact could be more pronounced, potentially necessitating alternative bone-strengthening medications.
She cautioned against interpreting this temporary risk increase as a deterrent to starting HRT. The study’s strengths include its vast dataset and extended follow-up period, shedding light on an often-underestimated aspect of women’s healthcare. A 2023 study by the National Osteoporosis Foundation indicated that nearly half of all women over 50 will experience a fracture in their lifetime, highlighting the critical need for preventative strategies at all life stages.1
Transition periods in women’s health, whether in primary care or specialized appointments, require greater attention than they currently receive, according to Dr. Kwolek.
1 National Osteoporosis Foundation. (2023). *Osteoporosis Fast Facts*. Retrieved from [Insert actual URL for NOF Fast Facts if available, otherwise omit or replace with a generic placeholder like a government health site fact page]
