#BodyTalkWithCosmo: Can hormone replacement therapy save your bones?

When women think about menopause, the first thing that usually comes to mind is hot flashes, followed by mood swings and hormonal changes. But there’s a quieter threat lurking in the background—bone loss. And while Hormone Replacement Therapy (HRT) has been a topic of debate for years, it’s now re-entering the chat as a potential safeguard against osteoporosis.

So, is HRT the unsung hero of bone health? Or is it a risk not worth taking?

What HRT does—and why it is so important for bone health

“HRT is for the ladies,” says Dr Lokesh Naik G, Senior Consultant, Orthopaedics at Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai. "Women have two main hormones—estrogen and progesterone. Estrogen, in particular, plays a huge role in calcium metabolism and bone building.”

As women reach the peri-menopausal stage, estrogen levels begin to drop. “After menopause, it’s almost zero. That means the body’s natural bone protection mechanism comes to a halt,” explains Dr Naik. “HRT, in essence, is just giving it back to the body—to protect it.”

But here’s the catch: Risks vs. rewards

Despite its bone-boosting benefits, HRT isn’t a free pass. “There are side effects. When we start this treatment, a woman who has stopped menstruating may start having cycles again,” Dr Naik warns.

More concerning, however, are the long-term complications. “The endometrium—the inner lining of the uterus—can get overstimulated. That can lead to malignancies like breast cancer, blood clotting, and heart-related issues. That’s why it’s not broadly recommended.”

So while it can temporarily improve bone density and relieve menopausal symptoms like hot flashes, irritability, and vaginal dryness, it isn’t a one-size-fits-all solution. “It’s best given for a shorter duration—to make a woman comfortable. But eventually, you have to come back to more sustainable treatments, like combination therapy.”

It's not for everyone, and definitely not forever

Dr Naik is clear: HRT is not a long-term solution. “You have to stop it eventually. And you need to weigh the risks seriously, especially if there’s already a family history of cancer.”

“If the woman already has symptoms or underlying risk factors, you’re only putting her at greater risk.”

In other words, HRT isn’t for everyone. But in the right context, for the right woman, and for the right period of time, it can be a powerful tool to protect bone health during a critical window of hormonal change.

Final word

Hormone Replacement Therapy might not be perfect, but for some women, it could act as a short-term safety net, giving bones a fighting chance during menopause’s most disruptive years.

Still, it’s not something to DIY or dive into blindly. Talk to your doctor, get a BMD test, understand your family history, and then decide whether HRT is a friend or foe for your future bone health. 

All images: Getty Images

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