If you searched for whether estrogen plus testosterone raises bone density, the short answer is that a small study of 51 women found a significant rise in bone density scores at the lower spine (lumbar spine) on estrogen plus testosterone. The femoral neck and hip stayed stable, and estrogen alone showed no significant rise at any of the three sites. The study measured bone density scores, not fractures.
What did the estrogen plus testosterone bone density study find?
The results come from a press release issued by The Menopause Society ahead of a presentation at the Society’s 2026 Annual Meeting in San Diego, October 20-24, 2026. The study is titled “Effect of Combined Estrogen and Testosterone Therapy on Bone Mineral Density in Postmenopausal Women.” The lead author is Sona Davis of the Keck School of Medicine of the University of Southern California.
The release calls it a small study of 51 women, followed for an average of 4.1 years. Women took estrogen for a mean of 3.5 years and estrogen plus testosterone for a mean of 3.1 years. Bone mineral density was measured with DEXA scans at three points: at baseline, after at least one year of estrogen alone, and after at least one year of estrogen plus testosterone.
| Bone site | Estrogen alone (T-score change) | Estrogen plus testosterone (T-score change) |
|---|---|---|
| Lumbar spine | No significant increase | Significant increase |
| Femoral neck | No significant increase | Stable |
| Hip | No significant increase | Stable |
A T-score compares your bone density with that of a healthy young adult. The NIAMS guide to bone mineral density tests lists a T-score of -1 or higher as healthy, -1 to -2.5 as osteopenia, and -2.5 or lower as a possible sign of osteoporosis. The release does not report how large the lumbar spine change was, so you cannot tell from it how far the score moved.
The researchers concluded that testosterone may have a synergistic effect with estrogen on trabecular bone, the spongy inner bone, especially at the spine. They suggest it may offer added skeletal benefit beyond estrogen alone. Davis said the team hopes the findings will encourage more research into how testosterone could be used safely and effectively as part of individualized menopausal care.
How strong is this result?
On the numbers the release gives, this is an early, small signal at one bone site. Three limits matter most for your decision:
- Group size. 51 women is a small group, and the release gives no subgroup numbers.
- What was measured. The outcome is bone density T-scores from DEXA scans. The release does not report any fracture outcome.
- Which site changed. Only the lumbar spine rose significantly. The femoral neck and hip were stable.
The design also limits what the result can show. The measurements were taken in sequence in one group: baseline, then after estrogen alone, then after estrogen plus testosterone. The release does not say whether women were randomized, and it does not mention a control group. Understanding clinical study design explains why randomized trials and other designs give different kinds of answers.
The release describes a meeting presentation and does not cite a published full paper. That means the full methods and data have not yet appeared in a peer-reviewed article. How to read a clinical study lists what to check once a full paper is available.
How does this compare with the 2019 Global Consensus?
The 2019 Global Consensus Position Statement on testosterone therapy for women, by Davis SR and colleagues, reviewed the available data and found that it did not support an effect of testosterone on bone mineral density at the spine, total hip or femoral neck at 12 months. The consensus rated that finding Level I, Grade A.
The two findings differ in follow-up (12 months in the consensus; an average of 4.1 years in the 2026 release), and the release does not give enough design detail to explain why the results differ. The consensus looked at 12 months. The 2026 release describes an average follow-up of 4.1 years, with a mean of 3.1 years on estrogen plus testosterone. The release does not report randomization, a control group or the size of the change, so the two findings cannot be reconciled from the release alone.
The consensus also called for adequately powered randomized trials of testosterone on the musculoskeletal health of women, with bone density and fracture risk among the outcomes. It noted that the trials it reviewed were of relatively short duration. The 2026 release does not report fracture risk and does not say whether the study was randomized, so the trials the consensus asked for remain an open question. The consensus also said there are insufficient data to use testosterone for any other symptom, condition or disease prevention.
What about side effects and availability?
The 2019 consensus reports that testosterone is associated with mild increases in acne and in body or facial hair growth in some women. It did not find an association with hair loss, enlarged clitoris or voice change. It also states that the safety of long-term testosterone therapy has not been established. The 2026 release does not report side effects.
The consensus also noted that, at the time, no female testosterone product was approved by a national regulator. The FDA consumer update on hormone replacement therapies covers approved hormone therapies that relieve hot flashes, night sweats, vaginal dryness and painful sex, and notes that these may reduce the chance of osteoporosis. That statement is about approved hormone therapies, not testosterone.
What else do people consider for bone density after menopause?
The release lists weight-bearing and resistance exercise, adequate calcium and vitamin D, and hormone therapy as methods to help protect bone health. It says standard estrogen therapy significantly lowers the risk of spine and hip fractures. It also says women can lose 10% to 20% of bone density in the first five to seven years after menopause.
A bone density test shows where your bone density falls. According to the NIAMS guide, these tests can identify and diagnose osteoporosis, measure fracture risk and monitor treatment. The guide also notes that the U.S. Preventive Services Task Force recommends bone density testing for women over age 65, and for younger postmenopausal women at increased fracture risk.
Questions to bring to a clinician
- What is my current bone density result, and what is my T-score?
- Is estrogen therapy an option for me, given my health history?
- If testosterone were considered, what product, dose and monitoring would be involved, and is any product approved for women where I live?
- How would exercise and calcium and vitamin D fit into my bone health plan?
The study answers one question for one group of 51 women at one bone site. It does not show whether estrogen plus testosterone changes fracture risk.
By ClinicalStudyConnect.com Research Desk
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.