The benefit of menopausal hormone therapy on bone density and microarchitecture persists after its withdrawal

Abstract

Context: Menopausal hormone therapy (MHT) favorably affects bone mineral density (BMD). Whether MHT also affects bone microarchitecture, as assessed by trabecular bone score (TBS), has never been evaluated. Objective: Our objective was to assess the effect of MHT on TBS and BMD before and after its withdrawal. Design: This was a cross-sectional study. Setting: This study included the general community. Patients or other participants: Data were collected from the OsteoLaus cohort (1500 women aged 50-80 years). After exclusion of women with bone-modulating treatments, 1279 women were categorized according to MHT status into current (CU), past (PU), and never (NU) users. Main outcome measure(s): Spine TBS and BMD at lumbar spine, femoral neck, and total hip were assessed by dual X-ray absorptiometry. Results:Age-andbodymassindex-adjusted analysisshowedhigherTBSvalues inCUvsPUorNU(1.31± 0.01, 1.29 ± 0.01, and 1.27 ± 0.01, respectively; P <2 years). Conclusion: MHT is associated with bone microarchitecture preservation, as assessed by TBS. The effect of MHT on TBS and BMD persists at least 2 years after withdrawal.