Bone Fracture Risk Spikes After Stopping Menopause Hormone Therapy

Bone fracture protection offered by menopausal hormone therapy vanishes within one year after the treatment ends (1^✔ ✔Trusted Source
Discontinuation of menopausal hormone therapy and risk of fracture: nested case-control studies using routinely collected primary care data

Go to source). Published in Lancet Healthy Longevity, experts at the School of Medicine, University of Nottingham, found that once women stop hormone therapy, they experience a temporary increase in fracture risk compared to those who never used it. Over time, this elevated risk reduces and eventually falls below that of never-users.

Fracture Risk Pattern Post Hormone Therapy

This investigation, supported by the National Institute for Health and Care Research SPCR, examined the biological effects of menopause, particularly the drop in estrogen levels that can lead to both physical and psychological symptoms.

Estrogen deficiency is also known to weaken bones with age. While the hormone component in therapy is recognized for reducing fracture risks during treatment, there are concerns tied to prolonged use, such as heightened risks of breast cancer and blood clots. As a result, prolonged therapy is generally discouraged.

Because of this, it’s important for patients and clinicians to understand the lasting impact of the treatment once it’s discontinued. Previous data was limited and often inconsistent, mostly covering the initial years after stopping hormone use.

Analysis of 6 Million Women's Health Records

This new analysis examined data from six million women across 2,000 general practices in the United Kingdom, allowing for follow-up periods of up to 25 years. Researchers matched women who had a first-time fracture with others of the same age and from the same practice who had no record of fractures. The team then compared the use of hormone therapy among these groups.

Dr. Yana Vinogradova, lead author and part of the Centre for Academic Primary Care at the School of Medicine, explained that women actively using hormone therapy showed reduced fracture risk. Notably, the risk patterns shifted once therapy was stopped.

Fracture Risk Timeline and Implications

Dr. Vinogradova outlined that the protective effect fades entirely about one year after discontinuation. Then, fracture risk rises and peaks around three years later. After roughly a decade, the risk drops to match that of women who never used hormone therapy and then continues to decline beyond that.

This trend was consistent across all types of menopausal hormonal treatments, although the extent of increased risk depended on the type of therapy and how long it had been used.

Supporting Treatment Decisions and Monitoring

According to the findings, visual models showing fracture risk over time could help patients and physicians weigh therapy options. Understanding the periods when fracture risk is highest can help in planning preventive strategies like bone health assessments at the time therapy is stopped. Women with additional risk factors, including lack of exercise or smoking, may require closer monitoring.

Dr. Vinogradova concluded by saying that these patterns open up new possibilities for further clinical and biological exploration into menopausal hormone treatments.

To sum up, menopausal hormone therapy offers protection against bone fractures while in use, but this benefit fades within a year after stopping treatment. The risk of fractures temporarily increases before gradually returning to levels similar to or lower than those in women who never used the therapy. These insights are crucial for healthcare professionals and patients in making informed decisions regarding treatment duration and post-treatment monitoring.

Reference:

1. Discontinuation of menopausal hormone therapy and risk of fracture: nested case–control studies using routinely collected primary care data - (https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(25)00048-0/fulltext )

Source-Medindia