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[Cassie]

Hi Ladies, I recently had a Bone Density Scan which shows I have fairly significant Osteoporosis. I would not know so as I am very active and feel I have strong bones. I am thin but always have been and went through an early Meno but have been on Oestrogel for that. I am only on one pump but the Dr has said I will need to have further treatment, not sure if that will involve upping my HRT dosage.  I am not keen on Bisphosphonates. Anyone had any success with just HRT at a decent dosage, my last Oestrogen reading was very low but only using 1 pump so perhaps the thing would be to up it to 2 but will discuss with the Dr. Any natural supplements that can help? Thanks Ladies.

[Bungo]

From what I've read, levels of 250 and above are best for bone density. I'm taking hrt primarily for bone density and for 2 years I was using oestrogen but not absorbing and my density declined a bit. So I'm anal now about ensuring I'm absorbing the patch and reaching optimal levels. I'm only at 180 on 50mg patch so going  to GP tomorrow to ask if can increase to 75. It can only help my symptoms too ( primarily chronic pain). Is there a reason you're only on 1 pump? That's not a typical dose

[Cassie]

Thanks for you response, well I have been on HRT for many years and figured its probably time to taper down the dosage to 1 pump as I dont really get symptoms at all.... will up it again. How long would one have to wait before having another scan to see if the bone density is improving? Sorry I am totally clueless regarding Osteo

[Mary G]

Cassie, I'm sorry to hear that.  When you say your oestrogen levels were low, how low are we talking?  As Bungo says, you need to aim for about 250-300 pmol for bone protection and I find I get to that level with one pump of Oestrogel (Oestraclin actually which is the Spanish equivalent) but obviously everyone absorbs products differently - I stick with one pump of Oestrogel so that I can safely continue with my progesterone gel.

You will probably need to increase to two pumps of gel and then have another DEXA scan in about a year.  Will the NHS agree to blood tests to make sure your oestrogen level has increased?

[CLKD]

Sorry to read this.  Is there any particular reason for low bone density?   Was it a pelvis/hips X-ray?

Brisk walking will help as bone impaction encourages new formation.  As does chewing our food, keeping the jaw bone healthy.

Bisphosphonates - why not?

[bombsh3ll]

Definitely increase the estrogen to a therapeutic level!

It makes me so sad how many women end up with osteoporosis needlessly due to under treatment.

Bisphosphonates have some really toxic side effects and have to be taken early in the morning before anything else and then stay upright for a period of time afterwards as they corrode the oesophagus.

They are less effective than estrogen and.have a negative impact on quality of life whereas estrogen improves it.

More than half of people quit taking a bisphosphonate in the first year as they are so unpleasant. Sadly these patients often go without further treatment, many of them women who have been persuaded to come off or not take estrogen, which is then virtually never reinstated.

They also don't help the intervertebral discs like estrogen, nor have the other health benefits eg cardiovascular, urogenital, skin, brain.

In my opinion bisphosphonates should only be offered to women if there's a clearly defined reason why hormone therapy cannot be used, as this is a far superior and safer treatment.

Obviously lifestyle is important but why wouldn't someone be doing all those things anyway - a healthy lifestyle is required in addition to treatment, not instead of.

Both my parents have osteoporosis and they are the typical candidates, slim and health conscious. My mum thought HRT wasn't natural - neither is the metal plate that's now in her wrist!

[Ayesha]

A youngish family member just diagnosed with osteoporosis after years of a dairy free diet has flatly refused to take Bisphosphonates and reluctant to take HRT because of a close family history to breast cancer.

She is filling up on vitamin supplements but leaving out calcium because that's also not good because of its side effects. Time will tell if she decides to take the HRT route, personally I think she should.   

[bombsh3ll]

Do have a word with her about tibolone or even raloxifene.

I wouldn't touch bisphosphonates either but going completely untreated is madness.

[Ayesha]

I have the ability to clear a room with the mere mention of HRT, no wonder there is so much ignorance and lack of knowledge about the subject.
Women only want to know when it becomes a desperate situation, my experience from a massive family mainly ageing women, we honestly are our own worst enemy!
 

[joziel]

This is what happens when they put women on starvation rations of estrogen.

So many women think they are getting All The Good Things with HRT, on their 1-2 pumps or 25-50 patches... and then - wham - they get one of the diseases HRT is supposed to help prevent. And it turns out they have hardly any estrogen because they weren't absorbing it.

It's ridiculous. Unless women educate themselves and then advocate for themselves, they lose out. Again and again.

[CLKD]

Where is the British Menopause Society in all this? 

As a meander: since the 1980s more youngsters have gone on 'diets' from an early age = risk of bone thinning.  Local Authorities sold off acres of school playing fields for housing ........

I hated cross country, hockey - often cold and wet  but we did skipping, cycling, walking because Dad had the car for work. Recently I saw on the local news about children having 30. mins of walking/running mid-morning to liven up their minds.  They seemed 2B enjoying it. 

Even so, my paternal grandma had a Dowager's hump although she had been active all her Life  .  She had a thyroid goitre removed when she was early 60s, died aged 84. 

[Mary G]

I agree with others who rightly point out the importance of HRT.  There are still far too many ignorant doctors who are anti HRT and wedded to those wretched, destructive and now completely discredited HRT studies conducted in the early 2000s but equally there are so many women who seem terrified of HRT. 

This an HRT friendly forum but we still get women on here who obviously need oestrogen badly but refuse to take it.  I think it's mostly out of fear but in some cases it seems to be something to do with toughing it out and doing things naturally, whatever that is supposed to mean.

So many women do themselves no favours at all - my sister refuses to even discuss the menopause or HRT.

[CLKD]

So why R those women here  ?  Unless it's to glean information .......... although not life threatening, as with diabetes for example, would these women avoid recommended treatment

[Jillyboo]

Sorry to hear that Cassie. Have you been advised to up your oestrogen dosage as part of your treatment?   

My mother had osteoporosis and always encouraged me to take HRT to try and prevent it. Thus far it seems to have worked. Mum was always very slim whereas I've never been very slim! I'm sure genetics plays a part.

Mum took bisphosphonates and calcium. It appeared to save her from fractures whenever she fell (regularly)!

In your position I'd be inclined to take any treatment advised. Osteoporosis can become disabling if left to its own devices. All the best going forward.

[Cassie]

Thanks ladies am seeing the Dr next week and will discuss upping the dosage. I am following on a group, mostly American based where it suggests the number of 60pmol- for bone protection, this sounds a bit low? Anyone have the confirmed min amt?