Effect of hormone therapy on lean body mass, falls, and fractures: 6-year results from the Women's Health Initiative hormone trials
Open accessAbstract
In Brief Objective: Loss of lean body mass with aging may contribute to falls and fractures. The objective of this analysis was to determine if taking postmenopausal hormone therapy (or HT: estrogen plus progestogen therapy or estrogen therapy alone) favorably affects age-related changes in lean body mass and if these changes partially account for decreased falls or fractures with HT. Methods: Participants randomly assigned to either estrogen plus progestogen therapy (n = 543) or control (n = 471) and estrogen therapy alone (n = 453) or control (n = 474) and receiving dual-energy x-ray absorptiometry scans to estimate body composition during the Women's Health Initiative were evaluated. Falls and fracture occurrence were obtained by annual self-report. Fractures were confirmed by a clinical chart review. Results: At 6 years postrandomization, lean body mass was not different between HT and control groups. Although lean body mass positively influenced bone mineral density, independent of HT status, the preserved lean body mass observed in the HT arms in the first 3 years did not significantly contribute to models evaluating HT influence on falls and fractures between years 3 and 6. Women taking at least 80% of their medication in the HT arms demonstrated fewer falls compared with placebo; this difference was not attributable to change in lean body mass. Conclusions: Despite early preservation of lean body mass with HT (3 y), HT did not ameliorate long-term (6 y) loss in lean body mass with aging. An evaluation of 6 years of hormone therapy in postmenopausal women enrolled in the Women's Health Initiative demonstrated that lean body mass preservation up to 3 years does not persist through 6 years of hormone therapy. Falling and fracture rates were not altered by this early lean body mass preservation.
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During menopause, the decline in estrogen levels is paralleled with a slight increase in injury risk and a decline in lean body mass.
“During menopause, the decline in estrogen levels is paralleled with a slight increase in injury risk and a decline in lean body mass (9).”
From Sex-Based Differences in Skeletal Muscle Kinetics and Fiber-Type Composition (2015) · cites this paper as [9]
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- Authors
- Bea, J. W., Zhao, Q., Cauley, J. A., LaCroix, A. Z., Bassford, T., Lewis, C. E., Jackson, R. D., Tylavsky, F. A., & Chen, Z.
- Affiliations
- University of Arizona (US)
- University of Pittsburgh (US)
- Fred Hutch Cancer Center (US)
- University of Alabama (US)
- The Ohio State University (US)
- University of Tennessee Health Science Center (US)
- Corresponding author
- Bea, Jennifer W.
- ORCID
- Venue
- Menopause
- Published
- 2011-01
- Volume
- 18
- Issue
- 1
- Pages
- 44-52
- ISSN
- 1072-3714 (ISSN-L)
- PMC
- PMC2991495
- OpenAlex
- W2030263270
- Cited by
- 55
- References
- 34
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 1 · 2023: 1 · 2022: 6 · 2021: 6 · 2020: 3 · 2019: 8 · 2018: 3 · 2017: 2 · 2016: 2 · 2015: 2 · 2013: 7 · 2012: 4
- FWCI
- 3.39
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Menopause The Journal of The North American Menopause Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health (n01wh32105-27-0-1, n01wh32108-30-0-1, n01wh32100-28-0-1, n01wh32118-27-0-1, n01wh42129-23-0-1, n01wh32111-28-0-1, n01wh32115-26-0-1, n01wh22110-38-0-0, N01 WH024152, n01wh24152-12-0-0, n01wh32122-31-0-1, n01wh32119-24-0-1, n01wh42107-22-0-1, N01 WH032100, N01 WH032108, N01 WH022110, N01 WH032105, N01 WH032118, N01 WH042129, N01 WH032115, N01 WH032119, N01 WH032111, N01 WH042107, N01 WH032122)
- U.S. Public Health Service (44221, 32122, 24152, 42107-26, 32118-32119, 32100-2, 32105-6, 32108-9, 32111-13, 32115)
- National Cancer Institute (CA-78447, R25CA078447, T32CA078447)
- National Center for Research Resources (UL1RR025755)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Keywords
- hormone replacement therapy, estrogen therapy, lean body mass, falls, fracture, bone mineral density, aging, Women's Health Initiative, body composition
- MeSH terms
- Accidental Falls, Aged, Aging, Body Weights and Measures, Double-Blind Method, Estrogens, Female, Humans, Longitudinal Studies, Middle Aged, Progestins, Time Factors, Absorptiometry, Photon, Bone Density, Estrogen Replacement Therapy, Proportional Hazards Models, Postmenopause, Muscle, Skeletal, Adiposity, Fractures, Bone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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