ENDO 2026: Menopause hormone therapy may offer more than symptom control

By Elizabeth PrattFact-checked by Davi ShermanPublished June 14, 2026

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It’s nice that we see these benefits because it means we can prescribe hormone therapy to women who aren’t symptomatic but want to be on hormones anyway.

—Karen Adams, MD

There are some women for whom giving hormone replacement therapy might be too high-risk, and I think it’s important that we not forget about those women. A lot of those women are still undergoing really debilitating vasomotor symptoms.

—Alyssa Dominquez, MD

A variety of studies to be presented at the ENDO 2026 conference suggest benefits of hormone therapy for bone health and of nonhormonal therapy for depression and anxiety among women in menopause.

One study found that menopausal hormone therapy (MHT) was associated with a 69% lower risk of low bone mineral density (BMD) in postmenopausal women, even after adjusting for other factors.^[]

“In this real-world cohort, menopausal hormone therapy was strongly and independently associated with higher bone mineral density and a substantially lower risk of low [bone mineral density]. These findings suggest that, beyond symptom control, [menopausal hormone therapy] may represent an underutilized strategy for bone preservation in appropriately selected postmenopausal women, particularly within the early postmenopausal window,” the researchers write in their abstract.^[]

The research expected to be presented is a small retrospective study, but experts say the findings highlight how hormones can benefit bone health.

“The American College of Obstetricians and Gynecologists (ACOG) recommends that estrogen therapy alone—for patients without a uterus—or combined with a progestin, can be considered for the prevention of bone loss and fracture in women at increased risk. Menopausal hormone therapy significantly increases BMD at all skeletal sites. Research shows that after 2 years of menopausal hormone therapy, BMD increased by 6.8% at the lumbar spine, 4.5% at the forearm, and 4.1% at the femoral neck.^[] These benefits are observed with both opposed (estrogen plus progestogen) and unopposed estrogen regimens,” Karen Adams, MD, a clinical professor of obstetrics and gynecology at Stanford University, tells MDLinx.

“It’s nice that we see these benefits because it means we can prescribe hormone therapy to women who aren’t symptomatic but want to be on hormones anyway. There are clear benefits to the bones when women take hormones,” Dr. Adams adds.

While the study authors suggest that menopausal hormone therapy may be underutilized in preserving bone health in menopause, experts say it is just one of many strategies to keep bones healthy.

“[Menopausal hormone therapy] should be considered as part of a broader, individualized approach. Lifestyle factors remain essential: regular weight-bearing exercise, a well-balanced diet, adequate vitamin D, and avoiding smoking all meaningfully impact bone health. For women already considering MHT for symptom relief, bone protection may be an added and important benefit,” Ruthann Devera, MD, an OB/GYN at MemorialCare Medical Group in Long Beach, CA, tells MDLinx.

Nonhormonal therapy reduces depression and anxiety

Other research being presented at the conference suggests that the nonhormonal therapy fezolinetant not only improves vasomotor symptoms but also depression and anxiety among women in menopause.^[]

Alyssa Dominguez, MD, an endocrinologist with Keck Medicine of USC, says the findings are helpful when considering patient populations for whom hormone-based therapies are not suitable.

“There are some women for whom giving hormone replacement therapy might be too high-risk, and I think it’s important that we not forget about those women. A lot of those women are still undergoing really debilitating vasomotor symptoms,” she tells MDLinx.

“It’s really great to see that there are some newer medications on the market that address some of those things. So, while we may not be able to give estrogen, there are other medications that we can give that might be helpful with those vasomotor symptoms, like hot flashes, [and] other medications that we can use for fracture prevention. So it’s thankfully not an all-or-nothing conversation of either you get estrogen, or you get nothing at all,” Dr. Dominguez adds.

HRT and thyroid cancer

Other research being presented at the conference demonstrates an association between a longer reproductive span and a progressively increased risk of thyroid cancer.^[] The same research also showed an association between prolonged hormone replacement therapy use and increased risk of thyroid cancer.

But Dr. Adams notes there is no evidence from the study that would require a shift in clinical practice.

“There is nothing in this research that would lead to a change in counseling patients related to the risks and benefits of hormone therapy use," Dr. Adams says. "Hormone therapy use should be discussed in light of the potential impacts on heart, bone, and breast health, as well as [the] benefits for symptom management. There is no strong data linking hormone therapy use and thyroid cancer.”

“It’s important to recognize that just because women with thyroid cancer tended to have longer reproductive lifespans and longer HRT use, that does not mean that those things cause thyroid cancer. There could be other factors at play that increase women’s risk for thyroid cancer and also prolong their reproductive lives or lead them to choose to be on HRT,” Dr. Adams says.

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