A new study presented at ENDO 2026, the annual meeting of the international Endocrine Society, has added to existing evidence that menopausal hormone therapy may help protect bone health in postmenopausal women.
Held in Chicago from 13 to 16 June, ENDO 2026 included new research across menopause, bone health, metabolic disease, obesity medicine and endocrine-related conditions, with several studies carrying relevance for clinicians managing patients through midlife and beyond.
MHT and bone density
The menopause hormone therapy study, presented by Diego Espinoza-Peralta, MD, MSc, Vice President of the Mexican Society of Nutrition and Endocrinology and principal investigator at Investigación Médica Sonora, examined bone mineral density outcomes in postmenopausal women who had undergone DXA scans between 2021 and 2025.
The retrospective cohort study included 387 postmenopausal women, 129 of whom were using menopausal hormone therapy (MHT) and 258 who were not.
Researchers found that women using MHT were significantly less likely to have low bone mineral density than non-users. Low bone mineral density, defined as osteopenia or osteoporosis, was identified in 31.8 per cent of women using MHT, compared with 56.2 per cent of those not using therapy.
After adjusting for age, time since menopause, vitamin D levels, smoking and other health conditions, MHT use was associated with an approximately 69 percent lower risk of low bone mineral density in the spine and hip.
‘For years, many women have avoided menopausal hormone therapy because of safety concerns and warning labels. This study revisits that narrative and shows that menopausal hormone therapy may have an important added benefit: protecting bone health. That shifts the conversation from “avoid if possible” to “reconsider in the right patient,”’ Dr Espinoza-Peralta said in a statement.
Bone loss accelerates after menopause as oestrogen levels decline, increasing the risk of osteopenia, osteoporosis and fragility fractures. The spine and hip are among the most clinically important sites for bone density assessment, given the impact fractures in these areas can have on mobility, independence and quality of life.
According to the Endocrine Society, women taking MHT had significantly higher lumbar spine and hip T-scores than those not taking therapy.
‘In simple terms: menopausal hormone therapy appears to independently protect bones, not just by coincidence,’ Dr Espinoza-Peralta said.
The findings are consistent with the recognised bone-protective effects of MHT, although the authors noted that the study was observational and cannot prove causation. Details of the specific hormone therapy regimens, routes of administration and duration of use were also not available.
The study adds to the broader conversation about individualised menopause care. MHT may offer benefits beyond symptom relief for some patients, but treatment decisions need to consider age, time since menopause, medical history, breast cancer risk, cardiovascular risk, uterine status and patient goals.
The findings may be especially relevant for women early after menopause, when bone loss can be more pronounced and long-term prevention strategies may have the greatest impact.
‘Clinicians may begin to weigh its benefits more carefully, especially in women early after menopause, potentially improving long-term health and quality of life,’ Dr Espinoza-Peralta said.
Metabolic health, menopause and long-term patient care
ENDO 2026 also included several studies relevant to metabolic health, menopause and long-term patient care.
One large study of more than 60,000 adults with type 2 diabetes found that GLP-1 receptor agonist use is often less continuous than expected. Around four in 10 patients stopped treatment within the first year and nearly six in 10 had stopped by two years, although more than half of those who discontinued later restarted therapy.
Another study found that adults with obesity reduced their physical activity after starting GLP-1 receptor agonist therapy. Daily steps fell from 5,047 to 4,487, while moderate-to-vigorous physical activity declined from 28 to 22 minutes per day. The researchers said the results reinforce the need to support exercise and muscle preservation alongside pharmacological weight loss.
Semaglutide was also linked with a 15 percent lower risk of fracture in people with type 2 diabetes compared with other anti-obesity medications, although further prospective research is needed.
In menopause care, real-world data on fezolinetant, a non-hormonal treatment for vasomotor symptoms, showed improvements in hot flashes, night sweats, depression and anxiety symptoms over 12 weeks.
The ENDO 2026 data reinforces the value of taking a complete patient history, particularly as more patients present with overlapping concerns around menopause, weight change, metabolic health, skin quality and body composition.
