Date of Award
2-2026
Degree Type
Selective Evidence-Based Medicine Review
Degree Name
Master of Science in Health Sciences - Physician Assistant
Department
Physician Assistant Studies
Abstract
OBJECTIVE: The objective of this selective EBM review is to determine whether or not hormone replacement therapy reduces bone resorption in postmenopausal women with an intact uterus.
STUDY DESIGN: A systematic review of three double blind randomized control trials (RCTs) published from 2016 to 2022.
DATA SOURCES: All RCTs were published in peer reviewed journals in English and were found on PubMed and Google Scholar. Articles were chosen based on relevance to the clinical question.
OUTCOME MEASURED: Level of bone resorption was measured via assessment of bone turnover markers at baseline and after use of hormone replacement therapy in all three RCTs. Bone turnover markers were assessed from serum or urine samples and measured via immunosorbent assay and electrochemical luminescence.
RESULTS: All three RCTs showed a significant reduction in bone turnover markers after hormone replacement therapy. Results by Costa-Paiva et al. showed reduction in P1NP of -19.33ng/ml (95% CI -23.6 to -14.9), CTX-1 of -0.09 ng/L (95% CI -0.14 to -0.04), and NTX of -8.74 nM/mM (95% CI -14.9 to -5.1) and increase in BSAP in the placebo group of 2.39 mcg/L (95% CI 1.1 to 3.9). Results by McClung et al. showed reduction in BSAP levels of -1.03 U/L (p< 0.05), P1NP levels of -13.94 ng/ml (p< 0.001), and CTX-1 levels of -0.11 ng/L (p< 0.001). Results by Honisett et al. did not show reduction in bone formation markers with BSAP levels decreasing -1.0 U/L and OC levels decreasing -0.5 ug/L (p>0.05), but bone resorption markers significantly decreasing with PYR by -16.9 nM/mM and DPD by -3.8 nM/mM (p< 0.05).
CONCLUSION: All three RCTs demonstrated that hormone replacement therapy reduces bone turnover markers, therefore decreasing bone resorption in postmenopausal women with an intact uterus. However, these studies have limitations that may affect their reliability, highlighting the need for further research before routinely prescribing HRT for the clinical treatment and prevention of osteoporosis. Future studies should include older patients and individuals with comorbidities, as well as evaluating the long-term effects of treatment.
Recommended Citation
Harding, Ashley, "Does Hormone Replacement Therapy Reduce Bone Resorption in Postmenopausal Women with an Intact Uterus?" (2026). PCOM Physician Assistant Studies Student Scholarship. 677.
https://digitalcommons.pcom.edu/pa_systematic_reviews/677