Date of Award
2027
Document Type
Capstone
Degree Name
Master of Science (MS)
Department
Physician Assistant Studies
Committee Chair
LaDonna Clark
Abstract
Introduction: Osteoporosis is a silent yet devastating skeletal disease disproportionately affecting postmenopausal women, increasing risk for debilitating fractures, loss of independence, and premature mortality. After menopause, estrogen declines causing rapid acceleration of bone loss, making early intervention critical. This clinical review evaluates whether hormone replacement therapy (HRT) reduces the risk of osteoporosis and osteoporotic fractures in postmenopausal women compared to no HRT.
Methods: PubMed was searched using terms including “Hormone Replacement Therapy,” “postmenopausal women,” “osteoporosis,” “bone mineral density,” and “fractures,” combined with MeSH terms and Boolean operators. Filters limited results to English, free full text randomized controlled trials (RCT), systematic reviews, and meta-analyses within the last five years. Six of 11 identified articles met inclusion criteria and were reviewed.
Results: Most included articles supported HRT as effective for reducing bone loss and fracture risk. The Women’s Health Initiative demonstrated a 24-39% fracture reduction with long-term use. Antiresorptive therapy was supported following HRT discontinuation to prevent rapid bone loss. Women with bilateral oophorectomy experienced greater hormonal decline and elevated fracture risk than those with natural menopause. Transdermal estrogen demonstrated a more favorable cardiovascular and thrombotic risk profile compared to oral.
Discussion: Evidence supports HRT as a safe, efficacious first-line option for osteoporosis prevention in postmenopausal women under 60 within a decade of menopause onset. Study limitations included small sample sizes and heterogeneous studies. HRT requires individualized clinical decision-making based on fracture risk, medical history, and patient preference. Further large-scale RCTs are needed to define optimal regimens and long-term outcomes across diverse patient populations.
Recommended Citation
Benfield KE. The Effect of Hormone Replacement Therapy on Osteoporosis and Osteoporotic Fracture Risk in Postmenopausal Women: A Clinical Review. The PA Department Journal of Medical Science. 2026. https://digitalcommons.gardner-webb.edu/pa-department-journal-of-medical-science/87
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License