Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Sarai on March 04, 2017, 03:28:09 PM
-
So this a a biggy for me, I've decided I will try hrt for osteoporosis.
I am 55 and just post meno.
I've read that an ultra low dose oestrogen works fine for osteoporosis so can anybody advise what ask for.
Psychologically I feel a patch or cream would be best for me.
I really need a lot of advice please
-
I wonder whether you have read the Osteoporosis Forum - sorry I can't remember the title but if you GOOGLE for UK Osteoporosis support it should take you to the correct place where you can read, join and post queries.
I had a look-see - The National Osteoporosis Society - there is a web-site and the opportunity to sign up to a newsletter ..... let us know how you get on!
-
Yes I have talked a few times to NOS nurses they are very good.
I just thought this group was where I would find good hrt info
-
You need to ask on the NOS as they will be au fai with HRT suitable for those who have been diagnosed with osteoporosis.
-
Can see it was a difficult decision. Well done for taking it. That's not meant to sound patronising as it isn't - I dithered for a long time before taking systemic HRT, and it was good to be able to talk to people on here who got that. I think Stellajane knows her stuff on bones and HRT.
-
Hasty yes I do have a womb so I know I will need progesterone it's just I read a gynae article that said a very low dose of oestrogen was adequate for the bones.
-
Ancient runner I know what you mean, it was very hard.
I wanted to manage without and did all the way past meno but hey lucky me got this instead.
-
Stellajane I looked at the hrt but non had information like they were licensed for osteoporosis, did I read the wrong section?
-
Stella Jane I didn't realise there was a star. Do you use it for osteo too
-
I honestly believe you take the medication that is designed for the problem - depression = antidepressants; menopause = HRT; and for loss of bone density you take the appropriate medications eg alendronic acid or similar.
I am of the understanding that you need to be on a medium dose of HRT for it to have any benefit for bone density, so an "ultra low" dose may have no impact at all.
Sorry, but you seem to have this mindset that everything has to come with absolutely no possible side effects or risks, but that is just not practical. Every medication comes with some kind of risk.
However the risks you are facing from osteopenia and osteoporosis are a far greater clear and present danger than taking bone density medications. I take Fosamax and I have absolutely no side effects at all. In fact the only side effect I have is that my bone density is much better.
The choice is yours of course, but I honestly think that, while HRT may assist with the problem, you also need to be taking the medication that is actually designed for your condition.
-
I agree with Dana!
I know how difficult it was for me to accept that I have to take anti-depressant medication for the rest of my Life but most days I remain well and am able to go out and about with my husband. I was scared to take medication in case it made me feel worse ....... I was scared to eat in case I felt worse. It was Very Hard Work! but 10 years down the line, I am a different person.
Read up as much as you can Sarai, contact those at the NOS and make notes of advice here. If you are able, brisk walking 10-20 mins. daily will help!
-
Am I doing something wrong, I click on the Treatments block but it wont take me in? Am also wanting to look at options for low dose hrt am thinking the patches will deliver the least compared to any other forms of hrt?
-
Hi Cassie - if you just hover the mouse on 'Treatments', you should then have a drop down menu which includes 'HRT Preparations'. If you click on this, you should get the various products. The only thing is I have the American version for some reason! It was the same yesterday as well!
Sorry, but I don't know the answer about low dose treatments, but I am sure someone will be along soon to help.
-
I have talked to the NOS and HRT is on their list of treatments for osteo and it always was the first line treatment as it's oestrogen that is the main factor in the osteo equation, though I know obviously other things like steroids can also wreck the bones.
My friend has severe osteo but after her first fracture she did 8 years of HRT on dr advice and was fine, it was after she quit and got no more advice that the problems began again.
And yes I do want no side effects, health anxiety has blighted me all my life, don't berate me for it. I can't help how I feel about the possible issues with bisphosphonates and I have a very sensitive system, I'm the twit, called one in a million by the drug company for getting a reaction to vitamin D.
-
Maybe Sarai: make a list of your symptoms, what you need to achieve as well as any worries about side effects. It took me about 3 lots of anti-depressant medication B4 we found one that helped. It's easy to pre-empt side effects but every medication has side effects: otherwise they wouldn't work ::). However, when we feel fragile and then get bombed by feeling worse >:(.
Let us know what you decide :-\ ???
-
Stellajane my main anxiety about bisphosphonates is jaw necrosis and though it may be rare it's not as rare as we are led to believe. Dentists will tell you this. And even if one person gets it that's a real person whose life is ruined.
Anyway that's my reason.
-
My Dental Surgeon: the one who did my implants very successfully : and who I love, a little bit :-* - never suggested necrosis.
[He did however suggest that no-one should have teeth removed and implants fitted on the SAME DAY because the body sees them as foreign bodies and might well reject the whole procedure. Teeth should be removed and the gums allowed to heal B4 any further procedure, bone density has to be measured ....... ]
See your Dental Surgeon Sarai ?
-
Hasty, yes I do a lady of 56 took alendronic acid for 4 years, she had no other drugs whatsoever and has jaw erosion and has to be seem at the hospital. The hospital and dentist blame the AA.
-
CLKD do you take bisphosphonates? If not my point is not relevant to your situation and implants.
All dentists must ask patients what medication they have and those on bisphosphonates should be off them at least 3 months before extraction. They are also asked to sign a disclaimer that they won't sue if it does not heal.
-
eh..... no, sorry, a bit of a meander ;)
-
Hi, some interesting views here. I was diagnosed with osteopenia (though on the cusp) when my periods were infrequent but still happening. My mother has osteoporosis and my sister who is two years older than me. When my periods stopped for 11 months, and I sought medical advice, mostly to tackle the sleep issues and low mood, I was advised by two doctors and one leading meno consultant to try HRT for osteopenia, given the impact of early menopause on bones etc. Talk of osteo medications came after that, if HRT wasn't successful.
I use oestrogel pump and have had the mirena coil fitted for minimum, non-systemic progesterone.
It was a huge decision for me too. Despite the meno issues I was having, I wouldn't have started HRT if it hadn't been for the advice re: osteoporosis
At no point did anyone suggest that I turn to osteo medications first.
-
Sorry, only just saw there were two pages of posts.
necrosis is very real - my mother has tooth issues and this was a very serious concern for her, and her dentist, when she started taking meds for osteo.
-
Just thought I would let you all know that I had my checkup today, after having my last bone density scan, and it's very good news. I have been on Fosamax (Alendronic Acid) for two years and there has been a density increase of 1.1% of the L2 and L4 vertebral bodies and a whopping 7% of the femoral neck. I am still less than what is "normal" for someone my age so it is recommended I continue with the Fosamax for at least the next two years until I have my next scan.
The decrease I experienced at my scan done two years ago was despite being on Estradot 50mcg patch and taking calcium supplements, eating dairy and exercising, so you can't always assume that those "standard" recommendations are going to work for everyone.
Regarding the issues of jaw necrosis etc, I specifically asked her about that and she said it is very rare and it mainly happens when it is injected, not with the once a week medications that most people take. This is exactly what my own research had already told me, so please don't believe the scaremongering that often goes on with some medications. We all know about the HRT scaremongering, which is also highly exaggerated.
Her opinion is that you have a much greater risk of your health being severely impacted by osteoporosis than you do from any side effects of the medication. I have no intentions of ending up like my father with a broken hip, so my choice is to continue with the medication. Everyone needs to make their own choices, but osteoporosis and osteopenia don't come with any symptoms, so it's impossible to know if you have it until you break or fracture something. Don't take that risk because the older you get the less likely you are to bounce back from a fracture.
Obviously medication shouldn't be the first option with osteopenia, but when you already have fractures of the spine, I would suggest you have already bypassed osteopenia, and I think you need something more than just HRT. However, that's just my opinion.
-
Great news that your bones density has increased Dana :)
I haven't read all of this thread but someone I know sent me this link today to some research just published about bisphosphonates which is relevant to the discussion - haven't had time to read it myself.
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_28-2-2017-13-6-7
Hurdity x
-
Shouldn't you at least read it prior to posting Hurdity? It might be rubbish.
-
That's great news, Dana.
Maybe I'll explore this at some point. I need another scan in the next few months. Will be interesting to see if all my exercise, food, calcium, and estrogel has made a difference.
But I have borderline osteopenia. Does it make a difference that I don't yet have osteoporosis?
-
Shouldn't you at least read it prior to posting Hurdity? It might be rubbish.
Ahem CLKD - don't tell me what I should and should not post!!!!!!!!!!! I think I can judge for myself what is rubbish or not. OK - reasons for posting - 1) I glanced at it and seemed it would be interesting 2) research by imperial college not wacky american website nor anything "whizzy whazzy" 3) I trust the judgement of the person who sent it to me - she wouldn;t send me anything "rubbish". I saw it was relevant....
OK?"!! ;D
Hurdity x
-
That's great news, Dana.
Maybe I'll explore this at some point. I need another scan in the next few months. Will be interesting to see if all my exercise, food, calcium, and estrogel has made a difference.
But I have borderline osteopenia. Does it make a difference that I don't yet have osteoporosis?
I think that if following the recommended precautions are working ie HRT, exercise etc, then that's great, but if it's not doing enough to help, medication is definitely the way to go. The risks of medication are minimal, but the risks of no medication are great.
I feel that it's best to start any necessary treatment while still in the osteopenia stage, if your doctor feels that the decrease in density warrants it. However the treatment standards may vary from country to country.
Here in Australia doctors aren't supposed to prescribe medication unless there has already been a fracture. My GP is very critical of that stance, and she and many other doctors will prescribe anyway if they feel it is necessary. All they have to do is basically tick a box to say the patient has confirmed they have had a fracture.
In my case she technically didn't tell a lie because I cracked a rib about 15 years ago. It probably had nothing to do with my bone density though. I had an extremely bad dose of the flu and the constant coughing fractured a rib. She had already ticked the box before I told her that though...lol
Anyway, the government is helping to address the problem because they have dramatically reduced the cost of the medication. I used to pay about $36 a month, but now I only pay about $8 a month.
-
The osteo meds aren't for taking indefinitely only for a period of years, but the HRT should continue to be taken.
I asked my GP about that and she said the recommendation used to be 10 years, but it has now been reduced to 5 years. It will be very dependant on age and deterioration though. Someone of my age (58) would probably stay on them for the 5 years and then be monitored with scans and have medication reinstated if necessary.
-
But you are lucky that you can tolerate Alendronic Acid, Dana. My sister and a friend had a terrible time on it, with the side effects, and both doctors I've seen were diplomatic, but clear, that osteo treatments aren't great
-
On Monday I see my dr about HRT which was the first line treatment for osteo until the 10 year ago hrt scare. The NOS still have it on their list of treatments.
I've studied this issue until I'm blue in the face.
Definite side effects, probable side effects, probable benefits of bone meds.
I have a friend who works for the NOS she fractured and went on HRT and was fine for 8 years only after coming off did her bones seriously deteriorate.
They now take people off meds after 3 years, there must be a good reason for this. Forsteo injections are only 2 years in a lifetime due to bone cancer risks of all things.
Like all things more research, no money, needs to be put into finding a safe way to grow new bone.
There some in the pipeline but guess what they need money.
-
If a treatment is designed to help why stop it after a set period of time? That's what I would be asking ......
Good Luck on Monday!
-
:thankyou:
-
Just to be clear, it may be different in the UK, but the time "recommendation" is 5 years in Australia. This is then at the doctor's discretion.
-
The recommendation in the uk is now 3 and then a break. Recently it was on the BBC that it has been shown to cause idiopathic fractures and also lots of micro cracks in bones.
-
Sarai, there is a long story in today's Guardian about this outlining the research, and pointing out that it was a very small study done in a particular way. It is quite a balanced piece - would be worth reading. It will be on their website.
-
I have to say Sarai that you seem to be purposely looking for negatives. You're getting fractures for goodness sake. You will always find some small study to prove anything you want about any kind of medication. Just look at all the "research" negativity you can find about HRT on the internet.
If HRT helps with your issues that's great, but I personally think you a doing yourself a great disservice to be so negative about a medication that has proven to help. It's proving to help me. However your choices are you choices. I'm doing well and that's all I'm interested in really.
-
Sarai, this is the Guardian article that ancient runner highlighted.
https://www.theguardian.com/lifeandstyle/2017/mar/13/breaking-bad-osteoporosis-prevent-treat-bones-bisphosphonates
-
:thankyou: that's ball-room dancing for me then - now I need to find a partner ::). Eating well in our teens is important so we should be encouraging our young people to eat a balanced diet with plenty of dairy, greens as well as regular exercise. I know that I don't take enough brisk exercise: note to self : but I am in our garden regularly at this time of year. I note too that my 90 year old relative is beginning to bend over so must encourage her to get a bone density scan ....... or ask her GP to check what her recent X-rays looked like.
Thanks for raising the issues! Any medication isn't without risks and there will often be a scare story - usually because someone has done a small 'study' and now wants a Research Grant ::)
-
Thanks for the link Elizabeth. As I suspected you need to read the article as a whole and not just take the part regarding the results of a very small study as gospel just because it suits your point of view.
It also confirms that, as I said, recommended treatment time is five years, not three Sarai. It just says it may be possible to treat for shorter periods as it tends to stay in the body.
As the article indicated, there may eventually be better treatments, but this is the best we currently have and I'm happy to take it because it's working well for me and there is no way I want to start getting fractures of the vertebrae.
Like I said though it's your call. I just hope that you get proper information from a doctor rather than internet "research".
-
Great news that your bones density has increased Dana :)
I haven't read all of this thread but someone I know sent me this link today to some research just published about bisphosphonates which is relevant to the discussion - haven't had time to read it myself.
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_28-2-2017-13-6-7
Hurdity x
I'm just quoting the original post I made way back in this thread the other day, about the research you mentioned on the BBC Sarai and what the Guardian article was about. Perhaps the link got missed (or rather perhaps a little de-railed...)? This is what was reported in the major newspapers and as ancient runner said best to read the original article to find out exactly what was researched - rather than journalist's take on it. However as she says the Guardian one is balanced - and probably the best source of scientific reporting in the media - ie closer to the actual research and usually with other relevant contextual information.
Those who missed it - do read the link if you want know more detailed information.
Hurdity x
-
Dana I do have to agree with you but as we've said its for each individual to decide.
When you've witnessed the effects of spontaneous vertebral fractures in someone close to you as I have it would be very negligent not to advise anyone to do all they can to help themselves.
This is not simply about breaking a bone or not if you have a fall. My mother would have retained her mobility and thus her independence had she not suffered these fractures.
Yes I agree. My father had no idea he had osteoporosis until he broke his hip. Of course being a man there isn't as much emphasis put on osteoporosis, but it can still happen to them too. It was then a steady and very painful decline over the next couple of years, with like your Mum his mobility being severely impacted, before he died.
-
Dana I am not deliberately looking for negatives. I know the negatives and so do drs if they are honest.
I know people with jaw erosion, I know people who have fractured on bisphosphonates many many times.
I have read scientific papers on exactly how they work which is totally against nature allowing our bodies to retain old bone so they look better on dexa.
Incidentally these drugs started life in industry as industrial cleaners.
-
Okay Sarai. I'm not going to argue with you. We all have to do what we think is best for ourselves. I happen to trust my research and my doctor's information, and for me I know it is working and that I am avoiding my osteopenia developing into osteoporosis. You may know people who have had fractures, but I had a father who found out he had osteoporosis when it was well advanced and he had broken a hip. His life expectancy after that happened was very limited and he died about 2 years later. That's all I need to know.