Randomized trials have demonstrated that menopausal hormone therapy significantly preserves bone mineral density and reduces vertebral, hip, and overall osteoporotic fractures.

In the Women's Health Initiative, combined estrogen-progestin therapy reduced hip fractures by 34% and total fractures by 24%, while meta-analyses demonstrate reductions in vertebral and osteoporotic fractures ranging from approximately 20% to 50%, depending on fracture type and patient population.

Cauley JA, et al. JAMA. 2003;290:1729-1738. The Menopause Society. The 2022 Hormone Therapy Position Statement. Menopause. 2022. International Osteoporosis Foundation. MHT and fracture prevention. Lobo RA, et al. Prevention of diseases after menopause. Am J Med. 2014.