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[Jari]

That's ok Butterfly!

What did they tell you to do when you were diagnosed with Osteopenia? Did they give you Calcium supplements and if they did, did they say to take 1200mg a day, twice 600mg? X

[MicheleMaBelle]

BeaR- great post. Thank you 💐

[Butterfly22]

That's ok Butterfly!

What did they tell you to do when you were diagnosed with Osteopenia? Did they give you Calcium supplements and if they did, did they say to take 1200mg a day, twice 600mg? X

They just said you have osteopenia, take calcium which o was getting off the doctor but it suddenly stopped. So just buy my own I'll have to check the strength. I don't drink or smoke gave that up 11 yrs ago xx

[Kathleen]

Hello ladies.

I am thin boned and had Ulcerative Colitis which can be a risk factor for Osteoporosis etc due to poor food absorption. Nevertheless  scans have never been mentioned.  Can I ask, has anyone been given dietary advice to protect their bones?

Thanks ladies and take care.

K.

[bear]

Thank you everyone for the links and additional information. It is a minefield and I know statistics can be interpreted in different ways. The fact the study is not a RCT means that it is not gold standard research as others have said.

What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.

We all weigh up risk and benefits and we should of course be able to make informed choices, but the studies are not robust as they do not take into account individal differences.

I do not want a doctor or nurse pratitioner telling me that the risks are too great and therefore do not wish to prescribe HRT, which for me makes the difference between being able to function and not.

What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.
We all have our own way of getting through this, it is an individual choice, and everyone should be supported in their journey.

Hi shrosphirelass,

 'Statistics can be interpreted in different ways'.

True, but I reckon the authors are well aware of that and I couldn't find any biased interpretation in this particular study. Have you?

'The fact the study is not a RCT means that it is not gold standard research as others have said.'

True, but many data used in this study is from RCT studies. The fact that this is a meta-analysis doesn't diminish the importance of this study.

'I do not want a doctor or nurse pratitioner telling me that the risks are too great and therefore do not wish to prescribe HRT, which for me makes the difference between being able to function and not.
What concerns me most is the effect this study may have on doctors and medical staff attitudes at a time when HRT is in short supply.'

It's likely that NICE and BMS will publish a comprehensive set of guidelines incorporating the new findings, so patients can 'educate' doctors and medical staff, IF they're not aware of it. It's time to be proactive.

'We all have our own way of getting through this, it is an individual choice, and everyone should be supported in their journey.'

Agree. In order to make an individual choice, we need all data analysis published and scrutinised.

BeaR.

[orrla]

Sorry, but,  where did you find any new findings!?

This were about old findings fro the very study that was later discredited as a flawed one!

So many doctors had already explained!

Links are in this thread.

Please go beyond the headline, however alarming it was, and how irresponsible by media was to publish it.

[Sparrow]

Sorry, but,  where did you find any new findings!?

This were about old findings fro the very study that was later discredited as a flawed one!

So many doctors had already explained!

Links are in this thread.

Please go beyond the headline, however alarming it was, and how irresponsible by media was to publish it.

Many existing studies were used in this new study, which was funded by Cancer Research UK and the Research Council.

All seems Kosher to me.

[Hurdity]

As has already been said by  Prof Michael Baum – the study is extremely complex and entails very involved multivariate statistical analysis in relation to a condition for which there are many confounding factors as all the medical experts have recognised and several of us have pointed out on here.

This is what he said: “This paper is extremely difficult to understand even by an expert like me, and I would need many hours to ingest it all”

Medical doctors (private or NHS, or both) have their own opinion on the matter, but that's what it is, their opinion. I wouldn't take their word as gospel, when many are on the hormone business.


BeaR.

I'm not sure what you mean here bear?  Because this is a statistical analysis of a collection of data it is all open to interpretation, including from the authors of the study.  The medical doctors (private and NHS) who have provided the main critiques of this study are forming an informed judgement based on the evidence. Do you mean that you do not trust their opinion – because they are “on the hormone business”? I really don't understand what you're saying. Of course they prescribe hormones – it is their job to prescribe appropriate licensed medication including HRT. There have been many informed responses to the study by leading gynaecologists and menopause specialists. I for one trust that they have read understood and digested this new study and have found its flaws and where appropriate recognised its strengths far better than I can with my limited understanding of it all.

Statistics can prove anything from anything about anything  ........ I worked with a few statisticians years ago  .  What I want is hard evidence, not possibilities or maybes. 

It is important to distinguish between a mechanistic or biological explanation for how things work – on individuals - (our bodies, our cells, and the effects of drugs and medications on our cells and hormones etc), and the effect on populations – which examines the differential effect of those treatments - because each individual will respond in a slightly different way even though the underlying biological principles are the same. Because we are genetically different including minute differences in our cells and enzymes etc then in order to find out if something works or not we need to carry out population studies and to be meaningful there has to be statistical analysis. We can't just say eg 55 % experienced this effect of a particular medication but 45 % didn't therefore it must work. We need to know how many people it was tested on and so forth. How you group the populations (and data) to be tested and the statistical analysis chosen can vary enormously and can influence the outcome and differential interpretation and is therefore open to criticism. This is especially important in discussion of risk and causality.

As yet, as far as I know the proposed mechanism whereby oestrogen actually causes breast cancer is not established – although there are explanations regarding oestrogen-receptive cancers and oestrogen causing these to grow ( when they have arisen by other means).  Re genetic factors and the BRAC gene – I don't know anything about this but not really the subject of this thread so won't get distracted. Also beyond my knowledge...

One other point that has been raised re doctors and practitioners telling us what we should and should not take. I like Prof Baum's point on this:

“In the modern era paternalism of the profession has been replaced by the principle of partnership whereby patients are helped to make informed decisions.”

I'd like to fly that as a banner in every surgery and clinic up and down the land!

Well said and please all of you take control of your own health and do not let any doctor or nurse tell you that you cannot take HRT (unless there is a very good specific medical reason why you should not do so) if you want to do so, nor take you off it against your will and without adequate reason.

Sorry got carried away there!

Prof Baum's statement has been linked to before but here it is again (from Louise Newson's website) for those who don't have time to read the whole thread:

https://www.menopausedoctor.co.uk/news/leading-breast-cancer-specialist-professor-michael-baum-responds-to-irresponsible-reporting

Re NICE - I understand (from another site) that they plan to send an alert to GPs after this news has come out and let's hope the alert is a balanced response and advice.

Hurdity x

[bear]

Sorry, but,  where did you find any new findings!?

This were about old findings fro the very study that was later discredited as a flawed one!

So many doctors had already explained!

Links are in this thread.

Please go beyond the headline, however alarming it was, and how irresponsible by media was to publish it.

'The clinical relevance of the main findings lies in the magnitude of the absolute risks during and after MHT use for women who start MHT at ages 40–59 years (figure 7; appendix pp 24–27), but the public health relevance depends additionally on the numbers of women previously and currently exposed. Although use of either type of MHT for less than 1 year was associated with little subsequent risk, for women of average weight in developed countries 5 years of use, starting at age 50 years, would cause an appreciable increase in the probability of developing breast cancer at ages 50–69 years. About half the excess would be during the first 5 years of current use of MHT, and half would be during the next 15 years of past use. The absolute increase would be about 2·0 per 100 women (one in every 50 users) for oestrogen-plus-daily-progestagen MHT, 1·4 per 10 women (one in 70 users) for oestrogenplus-intermittent-progestagen MHT, and 0·5 per 100 women (one in 200 users) for oestrogen-only MHT.
There is little difference in the absolute excess incidence by age 70 associated with starting 5 years of MHT use at
ages 45 years, 50 years, or 55 years. Thus, addition of a daily progestagen increases the excess risk of breast
cancer from one in 200 users to one in 50 users. The corresponding risks with 10 years of use starting at age 50 years would be about twice as great.'

The Million Women Study wasn't flawed. Are you confusing it with the Women's Health Initiative trial?

I don't take doctors words as gospel, as I have already said before.

I think I have gone far beyond the headlines and I'm very happy with this study. You seem to be very concerned, though. Why? Do you think newspaper headlines will define what doctors and nurses will do from now on?

BeaR.

[CLKD]

However: what's a Girl to do when the GP tells them that they won't be prescribing medication?  Which they are quite within their right to do.  These days there is so much risk to the of litigation. 

[orrla]

I brough this up with my Meno dr after my GP nagged me every three months about risks. She said it is my right to decide what I want to be on if I choose to be on HRT she has to give it to me.

So, I printed one from articles at that time, one about this very study bein discredited, and took it with me to GP.

It said very clearly that the risk is to women with large breasts, who are obese, and on booze.

Here is the best summary I've read so far:

1. Women who take HRT are less likely to DIE of breast cancer than those who've never taken it

2. Women who take HRT and do develop breast cancer have a significantly better 10 year survival (80%) than those who've never taken it (64%)

3. Women who take HRT have a lower all-cause mortality than those who've never taken it - due mostly to a substantially reduced risk of death from heart attack

4. The risks of being denied HRT far outweigh any from taking it, as there is a “Mortality Toll” from HRT avoidance

When I was deciding to go on HRT, which we all know that is not perfect, only one thing was known for sure, that it protects against Osteoporosis. My Grandma spent her last 5 years in bed with broken bones that could not be put back together from it, so genetically I am prone, hence my decision. I am 19 years on it, and intend to continue!

Best!

[CLKD]

I don't think that a GP has to prescribe anything even if a Consultant suggests it, if the GP doesn't think it is in the patient's best interests.  Which is why it can be such a battle.

Many++ years ago my GP said to me "What would you say if I told you that because of my Religion I won't prescribe the Pill?"  "You're personal feelings shouldn't come into it".  I got The Pill 

[Jari]

Hi Orrla, I'm surprised by that 4 point summary. Can you say where that came from? Ie who was it written by and where can I find it? Thanks.

[orrla]

Hi Jari,

I took it from an other post on this very thread, on page 4 or 5, I think..

[orrla]

CKLD, yes you can!

They have their hierarchy and must obey. If not, complain.

Fight for your rights!

or, go to meno clinic!