Menopausal Hormone Therapy and Osteoporosis: A Systematic Review
DOI:
https://doi.org/10.36557/2674-8169.2025v7n11p1608-1630Keywords:
osteoporosis, menopause, post menopause, hormone replacement therapy, systematic reviewAbstract
Osteoporosis is a disease characterized by low bone mineral density and deterioration of its microarchitecture, resulting in a highly porous structure associated with increased bone fragility and, consequently, an elevated risk of fractures. As a result, it is considered a public health challenge, predominantly affecting postmenopausal women, as this period is marked by a decrease in estrogen production, a hormone that plays a role in bone remodeling and repair, leading to significant morbidity and mortality. Currently, various substances aim to treat osteoporosis, including those that are analogous to or have similar actions to estrogens. However, there is no consensus among studies regarding the best therapeutic alternative, nor precision in clinical choices based on the individual characteristics of patients. Thus, this study aims to conduct a bibliographic review of hormone replacement therapies for osteoporosis in postmenopausal women. This is a systematic bibliographic review, analyzing studies that meet predetermined inclusion criteria from January 2018 to December 2023. The database used for consultation was PubMed. Through the results obtained in this review, it is expected to achieve a better understanding of the different hormone replacement therapies used for osteoporosis during the postmenopausal period. Consequently, it is also anticipated that this will lead to an improvement in the medical prescription of these substances, potentially enhancing the quality of life for those using medication for this purpose. Hormone replacement therapy has been shown to reduce serum levels of bone resorption markers, increase mineral density, and decrease the incidence of osteoporotic fractures compared to placebo. These results were more pronounced when therapy was administered to women aged up to 60 years or within 10 years after menopause. Therefore, prescriptions should be individualized, considering the risks and benefits for each patient. It is crucial to conduct further studies to correlate the efficacy of hormone replacement therapy with other available treatments during menopause.
Downloads
References
BARRETT-CONNOR, Elizabeth et al. The postmenopausal estrogen/progestin interventions study: primary outcomes in adherent women. Maturitas, v. 27, n. 3, p. 261-274, 1997.
BARZAMAN, K. et al. Câncer de mama: biologia, biomarcadores e tratamentos. Imunofarmacologia Internacional, v. 84, p. 106535, 2020.
CHEN, W. et al. “Advances in diagnosis and treatment of perimenopausal syndrome.” Open life sciences vol. 18,1 20220754, 2023.
FAUBION, S. S. et al. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, v. 29, n. 7, p. 767-794, 2022.
GENAZZANI, A. R. et al. Hormone therapy in the postmenopausal years: considering benefits and risks in clinical practice. Human Reproduction Update, v. 27, n. 6, p. 1115-1150, 2021.
GERSH, F.L.; LAVIE, C.J. Menopause and hormone replacement therapy in the 21st century. Heart, 2020.
HARA, T. et al. Pharmacological interventions versus placebo, no treatment or usual care for osteoporosis in people with chronic kidney disease stages 3‐5D. Cochrane
Database of Systematic Reviews, n. 7, 2021.
HENES, M.; HÜBNER, S. Hormone replacement therapy in peri-and postmenopause. Der Internist, v. 61, p. 558-564, 2020.
LEVIN, V. A.; JIANG, X.; KAGAN, R. Estrogen therapy for osteoporosis in the modern era. Osteoporosis International, v. 29, p. 1049-1055, 2018.
LI, H. et al. Association between HDL-C levels and menopause: a meta-analysis. Hormones (Athens), v. 20, p. 49-59, 2021.
LIN, S.Y. et al. Efficacy and safety of postmenopausal osteoporosis treatments: a systematic review and network meta-analysis of randomized controlled trials. Journal of Clinical Medicine, v. 10, n. 14, p. 3043, 2021.
LUNDBERG, G.; WU, P.; WENGER, N. Menopausal Hormone Therapy: a Comprehensive Review. Current Atherosclerosis Reports, v. 22(8), 33–, 2020.
MA, HY et al. Raloxifene in the treatment of osteoporosis in postmenopausal women with end-stage renal disease: a systematic review and meta-analysis. Hormone and Metabolic Research, v. 53, n. 11, p. 730-737, 2021.
NA, Z. et al. Role of menopausal hormone therapy in the prevention of postmenopausal osteoporosis. Open Life Sci, v. 18, n.1, p. 20220759, 2023.
OLIVEIRA, J. et al. Padrão hormonal feminino: menopausa e terapia de reposição. Revista Brasileira de Análises Clínicas, v. 48, n. 3, p. 198-210, 2016.
OUYANG, Y. et al. The effects of teriparatide and bisphosphonates on new fractures in postmenopausal women with osteoporosis: a protocol for systematic review and meta-analysis. Medicine, v. 100, n. 7, 2021.
PAGE, M. J. et al. A declaração PRISMA 2020: diretriz atualizada para relatar revisões sistemáticas. Revista panamericana de salud publica, v. 46, p. e112, 2023.
PINKERTON, J. V. Hormone therapy for postmenopausal women. New England Journal of Medicine, v. 382, n. 5, p. 446-455, 2020.
POGGIO, F. et al. Segurança da terapia de reposição hormonal sistêmica em sobreviventes de câncer de mama: uma revisão sistemática e meta-análise. Pesquisa e tratamento do câncer de mama, p. 1-7, 2022.
ROSSOUW, J. E. et al. “Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial.” JAMA, v. 288, n. 3, p.321-333, 2002.
ROZENBERG, S. et al. Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?. Osteoporosis International, v. 31, p. 2271-2286, 2020.
SCHROEDER, R.J. et al. Oral Therapeutics Post Menopausal Osteoporosis. Cureus,v. 15, 2023.
SHUFELT, C.L.; MANSON, J.E. Menopausal hormone therapy and cardiovascular disease: the role of formulation, dose, and route of delivery. The Journal of Clinical Endocrinology & Metabolism, v. 106, n. 5, p. 1245-1254, 2021.
THOMASIUS F., HADJI P. Einfluss einer Hormon- oder Hormonersatztherapie auf die
Knochenheilung [Influence of hormone or hormone replacement therapy on bone healing]. Unfallchirurg, v. 122,7: 512-517, 2019.
TRÉMOLLIERES, F. A. et al. Management of postmenopausal women: Collège National des Gynécologues et Obstétriciens Français (CNGOF) and Groupe d'Etude
sur la Ménopause et le Vieillissement (GEMVi) Clinical Practice Guidelines. Maturitas, v. 163:62-81, 2022.
WANG, Y. et al. Research Progress on the Etiology and Treatment of Premature Ovarian Insufficiency. Biomedicine hub, v. 8,1 97-107, 2023.
WILLEMS, Damon et al. Importance of Time Point–Specific Indirect Treatment Comparisons of Osteoporosis Treatments: A Systematic Literature Review and Network Meta-Analyses. Clinical Therapeutics, v. 44, n. 1, p. 81-97, 2022.
YANG, M. et al. Systematic Review and Meta-analysis: Changes of Gut Microbiota before and after Menopause. Disease Markers, v.2022, 2022.
ZIEL, Harry K.; FINKLE, William D. Increased risk of endometrial carcinoma among users of conjugated estrogens. New England journal of medicine, v. 293, n. 23, p. 1167-1170, 1975.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Débora Del Bianco, Fernanda Veck Sosa, Vinicius Cestari do Amaral
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
