Menopausal hormone therapy reduces the risk of fracture regardless of falls risk or baseline FRAX probability-results from the Women’s Health Initiative (WHI) hormone therapy trials

Serge Rozenberg

Mattias LorentzonHelena Johansson, Nicholas C HarveyEnwu LiuLiesbeth VandenputCarolyn J CrandallJane A CauleyMeryl S LeBoffEugene V McCloskeyJohn A Kanis (Osteoporos Int 2022 Nov;33(11):2297-2305. 

The authors combined the data of 25,389 postmenopausal women aged 50-79 years, enrolled in the two WHI menopuase hormone (MHT) trials, MHT vs. placebo and analysed the reduced risk of fracture regardless of baseline FRAX fracture probability and falls history. 

Results: Over 4.3 ± 2.1 years (mean ± SD), MHT (vs. placebo) significantly reduced the risk of any clinical fracture (hazard ratio [HR] 0.72 [95% CI, 0.65-0.78]), Major osteoporosis fractures (MOF) (HR 0.60 [95% CI, 0.53-0.69]), and hip fracture (0.66 [95% CI, 0.45-0.96]). Treatment was effective in reducing the risk of any clinical fracture, MOF, and hip fracture in women regardless of baseline FRAX MOF probability, with no evidence of an interaction between MHT and FRAX (p > 0.30). Similarly, there was no interaction (p > 0.30) between MHT and prior falls. 

Conclusion: In the combined WHI trials, compared to placebo, MHT reduces fracture risk regardless of FRAX probability and falls history in postmenopausal women. 


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