SYSTEMATIC REVIEW article
Front. Reprod. Health
Sec. Menopause
Volume 7 - 2025 | doi: 10.3389/frph.2025.1542746
Impact of Menopause Hormone Therapy, Exercise, and Their Combination on Bone Mineral Density and Mental Wellbeing in Menopausal Women: A Scoping Review
Provisionally accepted
- 1Sandwell & West Birmingham Hospitals NHS Trust, West Bromwich, United Kingdom
- 2University of Birmingham, Birmingham, England, United Kingdom
- 3Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom
- 4Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
- 5Aston Medical School, Birmingham, West Midlands, United Kingdom
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Osteoporosis, a condition marked by low bone mineral density (BMD) and structural deterioration, affects more women than men over 50, globally. In women, declining oestrogen during the menopause accelerates bone resorption, heightening fracture risk. An association between osteoporosis and depression, frailty fractures, depression and poor quality of life has been identified. Both menopause hormone therapy (MHT) and exercise are shown to improve BMD, with MHT reducing bone resorption and exercise promoting bone formation. This review examines the effectiveness of MHT, exercise, or their combination in managing menopausal osteoporosis.A multifactor scoping review was conducted to address osteoporosis and MHT, osteoporosis and exercise, and osteoporosis, MHT and exercise combined.Initial searches identified 15,158 studies, narrowed to 20 meeting the inclusion criteria. MHTMHT and exercise are effective in preserving BMD in menopausal women. Combined oestrogen and progesterone MHT is more effective than oestrogen-only, with studies suggesting that MHT prescribed at low doses for longer durations more effectively preserved BMD. Resistance training (RT) completed 2-3 days per week at a moderate-to-high intensity combined with impact activity completed at a minimum of 3 days per week is optimal for improving BMD in menopausal women, while low-impact exercises provide supplemental benefits. Combining MHT with exercise enhances BMD more than either alone.This review highlights that combining MHT and structured exercise is most effective for enhancing BMD in menopausal women. Given certain safety considerations surrounding MHT in some women, exercise remains a cornerstone for the prevention and management of osteoporosis as well as for promoting overall wellness.
Keywords: menopause1, Menopause hormone therapy, Exercise3, bone mineral density4, Osteoporosis5
Received: 10 Jan 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Platt, Bateman and Bakour. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Olivia Platt, Sandwell & West Birmingham Hospitals NHS Trust, West Bromwich, United Kingdom
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