HRT or Exercise for Stronger Bones After Menopause?

As oestrogen falls after menopause, bone breaks down faster than it rebuilds, and this review compared how well hormone therapy and weight-bearing exercise each protect against that loss. Across six studies, hormone therapy produced greater improvements in bone density and a lower risk of fracture at the hip and spine than exercise alone, while resistance and mixed-loading exercise still produced real, if more modest and variable, gains on its own. Neither option was investigated together often enough to say clearly whether combining them beats either alone, which the authors flag as a genuine and frustrating gap in the evidence. With only six studies meeting the criteria, this is an early rather than settled picture, and individual results varied by the type and intensity of exercise used. For a woman thinking about her bones for the decades ahead, it suggests hormone therapy carries the strongest protective effect where suitable, while weight-bearing and resistance exercise remains a genuinely worthwhile habit in its own right, with or without it.