Bone Health in Women During and After Hormone Therapy

When you're going through cancer treatment, you expect fatigue, hair changes, and appetite shifts, but bone health? Most women don’t see that one coming. Yet hormone therapy, especially for breast cancer, can quietly affect your bones more than you realize.

Whether you’re on treatment right now or have completed it, understanding how your bones change and what you can do to protect them can make a huge difference in how strong and confident you feel in the years ahead.

Why hormone therapy affects your bones

Hormone therapy works by lowering or blocking estrogen, which is a hormone that fuels some cancers. But estrogen is also your bones’ best friend. It helps keep them dense, strong, and supported.

So when estrogen drops, your bones can:

• Lose density faster
• Become weaker
• Increase your risk of fractures
• Make everyday movement feel a bit harder over time

This doesn’t happen overnight, but it’s a gradual change many women don’t notice until a scan or symptom appears.

Common treatments that impact bone health

Some cancer treatments that are known to influence bone strength include:

• Aromatase Inhibitors (Letrozole, Anastrozole, Exemestane)
• Ovarian Suppression (Leuprolide, Goserelin)
• Surgical Menopause (oophorectomy)
• Tamoxifen (protective in postmenopausal women, mildly weakening in premenopausal women)

Each treatment affects estrogen differently, which means the degree of bone loss can vary from woman to woman.

Signs your bones might need more attention

Most women don’t feel bone loss happening. But you might notice:

• More back or hip pain
• Feeling “shorter” than before
• Changes in posture
• Bones that fracture more easily

If you’re ever unsure, a DEXA scan is the simplest, most accurate way to check your bone density.

How to protect your bones during & after treatment

Small, consistent habits can help rebuild strength and slow bone loss.

• Load-bearing exercises like walking, stair climbing, dancing, or light weight training help keep your bones active and strong.
• Get enough calcium and vitamin D through food and supplements (if advised) to support bone building and repair.
• Ask your doctor about bone-supportive medicines such as bisphosphonates or denosumab if your bone density is low.
• Limit smoking and alcohol, as both can speed up bone loss, especially during hormone therapy.
• Schedule regular bone check-ups, including a DEXA scan every 1–2 years, to monitor bone density and catch early changes.

Your bones can stay strong

Protecting your bone health during and after hormone therapy is just as important as caring for your cancer. With regular check-ups, simple lifestyle habits, and the right medical support, you can stay strong, prevent fractures, and feel more in control of your long-term health