DIET & NUTRITION 
PATIENT EDUCATION 
OBESITY/WEIGHT MANAGEMENT 
EXERCISE/TRAINING 
LEGAL MATTERS 
GUIDELINES/RECOMMENDATIONS ℹ️ Observational Association Only Evidence
A retrospective cohort of 387 postmenopausal women found MHT users had a 69% lower adjusted odds of low bone mineral density than non-users, with low BMD present in 31.8% of MHT users versus 56.2% of non-users.
Clinical Considerations
- MHT users showed significantly higher T-scores at both the lumbar spine and total hip, the two sites most associated with fracture risk in older women.
- Groups were balanced on age, vitamin D levels, and years since menopause, though specific hormone regimens and administration routes were not captured.
- Findings echo the 2002 Women’s Health Initiative, which found a 34% reduction in hip fracture risk among hormone therapy users.
- Lead author explicitly cautioned the observational design supports association, not causality, given residual confounding from unmeasured regimen differences.
Practice Applications
- Consider MHT as one factor in bone health discussions for appropriately selected postmenopausal patients.
- Avoid framing this cohort data as proof that MHT prevents fractures.
- Interpret findings alongside individualized risk factors, including cancer and cardiovascular history.
