Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Stockport1965 on January 30, 2021, 05:07:15 PM
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I was really hoping at the age of 55 (probably went through menopause at 44ish) that I could go on HRT for my newly diagnosed osteoporosis.
GP said after the age of 51, I can't :'(
My T score is -3.1 spine and -1.6 hip. The 1st GP I spoke to said that I was borderline for meds but when I made another appointment for another GP, he said I should start now.
It is the dreaded Alendronic Acid that he wants me to take and the more I read, the more I want to bury myself under a duvet! I really don't know what to do.
I am going to ring the OP nurses at ROS to see what they say.
My gut is saying to me, to do all the new exercise programme as prescribed with the correct diet & supplements and have a private DEXA scan in 12 months to see if I go into the Osteopenic region again. (-1 and -2.5 )
Thoughts please, especially from anyone that has taken the meds
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What is reason you can't take HRT now, i am confused. I started HRT at age of 52, my MIL was prescribed HRT for her osteoporosis when she was over 60 but that was about 25 years ago.
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What is reason you can't take HRT now, i am confused. I started HRT at age of 52, my MIL was prescribed HRT for her osteoporosis when she was over 60 but that was about 25 years ago.
He said that they don't give it to women over 51 anymore. However, I have just read on the British Menopause Society that HRT remains licensed for osteoporosis prevention and can be considered the treatment of choice for women starting treatment below age 60 years, and especially for those with a premature menopause.
Perhaps I should get another opinion.?? I need to explore every avenue before taking this drug
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I think that the reason you can't take HRT is that not all of them are licenced to be used for oesteoporosis and then there are certain conditions that have to be met. It would be prescribable if you need treatment for other meno symptoms such as hot flushes, VA etc. Have you visited this site? https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/#:~:text=HRT%20for%20osteoporosis%20usually%20combines,pain%20caused%20by%20broken%20bones.
Taz x
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I think that the reason you can't take HRT is that not all of them are licenced to be used for oesteoporosis and then there are certain conditions that have to be met. It would be prescribable if you need treatment for other meno symptoms such as hot flushes, VA etc. Have you visited this site? https://theros.org.uk/information-and-support/osteoporosis/treatment/hormone-replacement-therapy/#:~:text=HRT%20for%20osteoporosis%20usually%20combines,pain%20caused%20by%20broken%20bones.
Taz x
I did discuss with him that I have "mild" flushes - nothing worse than that. We then went on to discuss that I should continue with Vagifem 4x weekly with Ovestin externally, so he knows I have VA.
I became a member of the ROS and I'll ring a nurse on Monday to see what they advise as well. :)
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I was really hoping at the age of 55 (probably went through menopause at 44ish) that I could go on HRT for my newly diagnosed osteoporosis.
GP said after the age of 51, I can't :'(
My T score is -3.1 spine and -1.6 hip. The 1st GP I spoke to said that I was borderline for meds but when I made another appointment for another GP, he said I should start now.
It is the dreaded Alendronic Acid that he wants me to take and the more I read, the more I want to bury myself under a duvet! I really don't know what to do.
I am going to ring the OP nurses at ROS to see what they say.
My gut is saying to me, to do all the new exercise programme as prescribed with the correct diet & supplements and have a private DEXA scan in 12 months to see if I go into the Osteopenic region again. (-1 and -2.5 )
Thoughts please, especially from anyone that has taken the meds
I started HRT patches at 56. The main reason was VA but I also had mild osteopenia and I wanted to prevent it getting any worse. I had had a Dexa scan in autumn 2018 which showed the osteopenia. I haven't yet had another one so I don't know whether it has made any difference.
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I started hrt t at 56 also, due to being unable to manage VA with Vagifem.
Maybe a different GP would prescribe it? I have never heard of being ineligible for hrt at 51.
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Have a look at the Royal Osteoporosis Society web-site?
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There is supposed to be a 'window of opportunity' fot hrt to help your bones. I *think* it's age 60 or 10 years post meno. Hurdity will be able to tell you if you can't find it elsewhere.
Age 51 is nonsense, I started it at 57 though I was peri. Maybe see a different gp and invent some more symptoms, or try an osteoporosis specialist. You should have been offered hrt long ago as you were so young at meno.
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There is supposed to be a 'window of opportunity' fot hrt to help your bones. I *think* it's age 60 or 10 years post meno. Hurdity will be able to tell you if you can't find it elsewhere.
Age 51 is nonsense, I started it at 57 though I was peri. Maybe see a different gp and invent some more symptoms, or try an osteoporosis specialist. You should have been offered hrt long ago as you were so young at meno.
GP admitted in hindsight that I should have had it.🙄
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Hi Stockport
I have Osteoporosis (T -2.7 in hip - spine is fine)
As the other have said, the 51 age cut off is nonsense - speak to your (or another GP) and emphasise hot flushes and VA just to get HRT full stop.
I tried Alendronic acid - did not get on with it at all. Eventually I got Denosumab twice yearly injections, still feel a bit off but it's far easier to tolerate that the Bisphosnonates. The thing is Alendronic acid has to be tried first before they will consider other approaches.
The NOS nurse helpline has provided wonderful help in the past - the last time I rang them the number was 0808 800 0035. Might be worth giving them a call.
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Hi
I'm in the same postion
I was aboutb 43 when I had my menopause, I'm nearly 51 now
I had a dexa scan 3 years ago which showed osteopenia in the spine, went to see Dr, who told me that although 43 was early hrt was for pre 40s according to nice guidelines so wouldn't prescribe it.
Had another dexa scan last month, and gone from -1.6 to -2
I think i need another chat
Bloody drs are supposed to help
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Gillybilly if your gp won't help you can ask for a referral to a menopause clinic. I would suggest you start having hot flushes and a few other symptoms.
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Hi
I'm in the same postion
I was aboutb 43 when I had my menopause, I'm nearly 51 now
I had a dexa scan 3 years ago which showed osteopenia in the spine, went to see Dr, who told me that although 43 was early hrt was for pre 40s according to nice guidelines so wouldn't prescribe it.
Had another dexa scan last month, and gone from -1.6 to -2
I think i need another chat
Bloody drs are supposed to help
is that hip or spine?
did you have the 2nd dexa on the same machne?
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I am 57 and take HRT for my bone health. I had a DEXA scan a few years ago that showed I have borderline osteopenia/osteoperosis. I also need it for other menopausal symptoms. It will be reviewed at aged 60 . I was offered the Alendronic Acid but I read up about it and I didnt want to take it unless absolutely necessary. My Dr at the time agreed I could try the HRT until aged 60 and have a scan to see how and if my bone health had improved or at least stabilized. I have moved since and have been prescribed HRT by different Doctors. None of whom have blinked an eyelid on my being on HRT.
I also, initially, went to see a private menopause specialist consultant who looked at my DEXA scan results and discussed treatment options. She advised HRT too. At the time I was 55.
I think the reason HRT isnt on the list of recommended treatments was because of the risks associated with HRT . Not because it doesnt work.
A second opinion via a specialist is always good. It really put my mind at rest. I hate using private channels but I had to go down that route as I needed that specialist input and answers that my Dr could not give. With covid these can be telephone calls and so easier.
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I have just been put on hrt for bladder and vaginal issues at age 61, had full hysterectomy at 51 so quite frankly this is rubbish! Would insist on it if I were you.
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I think the issue is HRT being prescribed for bone health alone. Throw in a few meno symptoms and it's probably prescribed without query.
Taz x
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Gillybilly if your gp won't help you can ask for a referral to a menopause clinic. I would suggest you start having hot flushes and a few other symptoms.
I completely agree, the idea that you are too old at 51 to start HRT is ridiculous! I started at 50 after years of peri menopause symptoms. See another doctor. The only reason a doctor should refuse you HRT is if it will be harmful to your health history if blood clots etc or strong family history if other conditions that contraindicated. NICE NHS guidelines state you are entitled to be referred to a menopause clinic.
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Hi
I'm in the same postion
I was aboutb 43 when I had my menopause, I'm nearly 51 now
I had a dexa scan 3 years ago which showed osteopenia in the spine, went to see Dr, who told me that although 43 was early hrt was for pre 40s according to nice guidelines so wouldn't prescribe it.
Had another dexa scan last month, and gone from -1.6 to -2
I think i need another chat
Bloody drs are supposed to help
is that hip or spine?
did you have the 2nd dexa on the same machne?
Its the spine.
My hips are -0.3 and my spine -2
2 dexas done on the same hospital machine.
I cant understand why it's such a huge difference between the two numbers
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More density in the pelvis. This is where most scans are taken .......... apart from the femur it's the bone which takes the body weight. So gets more impact.
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Hello
I'm another one diagnosed with osteoporosis. I am 52 and my T scores are - 1.8 hips and -2.5 spine. I also have VA. I've been trying to manage the VA and have had some success with Ovestin, although at a higher frequency than my GP is happy with. She also wants me to start Alendronic acid but like the original poster I am very wary of it. Some of the side effects sound potentially scary and even the stomach issues put me off. So after watching a video about HRT on Dr Louise Newson's website I'm thinking of asking for HRT instead for now and maybe later on, if I am told to stop the HRT, I will take the Alendronic acid.
Does anyone know if this is a good idea this a good idea?
I was really worried about HRT and breast cancer having had atypical cells removed but Dr Newson's video really reassured me.
I'd be really interested to know what you decided to do Stockport.
Does anyone out there know which is the best HRT to try for VA/Osteoporosis? I was thinking of asking for Oestrogel and Utrogestan.
Also I have beeen prescribed Calcium and Vit D supplements but have read that they can cause heart problems and kidney stones. I eat a fair amount of foods containing calcium and have taken a vit D supplement for a long time, so is it necessary to take these?
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TnToast - welcome to the osteoporosis club!
GP's want to prescribe AA as a 1st port of call. Have you been given your frax score? I had to ask for mine but you can do this online yourself.
I decided to go down the HRT - everol conti patch. I am going to have another scan in 3years. I had to fight for it, GP's aren't always up to speed on OP & HRT.
I was prescribed 2x calcichew D3 forte - presume it's what you have been given?? I don't take them now as I make sure I get enough calcium. Loving new things like chia seeds/beans & nuts etc. I take a vitamin D tab, Vitamin K2-mk7, boron & magnesium.
Have you done your research on weight bearing exercise? Stomping? Heel drops?
It's all a bit scary isn't it at the start....
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TnToast, I don't think there is a best HRT for osteoporosis, but it might be a good idea to get bloods done to measure your beta estradiol level once you get settled on a regime, to make sure you are absorbing enough oestrogen. I understand you need to reach at least 350 pmol/l for bone improvement. With Oestrogel it is easy to adjust the dose. Good luck.
JP x
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TnToast, I don't think there is a best HRT for osteoporosis, but it might be a good idea to get bloods done to measure your beta estradiol level once you get settled on a regime, to make sure you are absorbing enough oestrogen. I understand you need to reach at least 350 pmol/l for bone improvement. With Oestrogel it is easy to adjust the dose. Good luck.
JP x
That's really good info, I'd never considered that.
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Hi Stockport
I hadn't been given a FRAX score so I did it myself. From that it would seem that my risk of a major fracture is very low (2.5%) which makes me wonder why I have been offered treatment already. I rang the ROS and the nurse did say that I could wait the two years until my next DEXA if I was worried about the bisphosphonate, as the longer you have to take it the more risk of side effects.
However as I don't want things to get worse I have decided to ask for HRT in the mean time in the hope it slows the bone loss and maybe takes me back to osteopenia (is that possible?). I have been prescribed Calcichew D3 Forte like you but haven't taken it. I'm trying to increase my dietary calcium but I read/heard (cant remember which as I've done so much research lately!) that unless you have enough oestrogen the supplements don't help. I didn't know about the Vit K etc though. I already eat beans and nuts etc.
Also I'm doing 'Pilates for Osteoporosis' exercises from Instructor Live and I walk for 30m a day (thinking about jogging).
It is very scary and I hate having to think so much about how to bend and lift. I've always thrown myself around without a second thought up to now.. ;D
When I checked with the breast consultant about HRT he said Osteoporosis could be much worse and to take the HRT and just remember to check regularly.
Thanks for the tip about getting bloods done Joaniepat - I wonder if the NHS GP will be prepared to do this?
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Hi Stockport
I hadn't been given a FRAX score so I did it myself. From that it would seem that my risk of a major fracture is very low (2.5%) which makes me wonder why I have been offered treatment already. I rang the ROS and the nurse did say that I could wait the two years until my next DEXA if I was worried about the bisphosphonate, as the longer you have to take it the more risk of side effects.
However as I don't want things to get worse I have decided to ask for HRT in the mean time in the hope it slows the bone loss and maybe takes me back to osteopenia (is that possible?). I have been prescribed Calcichew D3 Forte like you but haven't taken it. I'm trying to increase my dietary calcium but I read/heard (cant remember which as I've done so much research lately!) that unless you have enough oestrogen the supplements don't help. I didn't know about the Vit K etc though. I already eat beans and nuts etc.
Also I'm doing 'Pilates for Osteoporosis' exercises from Instructor Live and I walk for 30m a day (thinking about jogging).
It is very scary and I hate having to think so much about how to bend and lift. I've always thrown myself around without a second thought up to now.. ;D
When I checked with the breast consultant about HRT he said Osteoporosis could be much worse and to take the HRT and just remember to check regularly.
Thanks for the tip about getting bloods done Joaniepat - I wonder if the NHS GP will be prepared to do this?
Your hips don't look too bad, just osteopenic?
GP's love to prescribe AA without considering other options.
Weight bearing exercises are a must, get some hand weights, mine are 2kg - these exercises should be done 2-3 times a week. You need to remember to shock your bones, hence doing heel drops daily throughout the day. On my morning 30min walk , I jog for 4x 45 secs. I've never run before so don't want to put pressure on my lower spine. The forum called "inspire" has been my lifeline
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Thanks for the info Stockport - just seen your pm - I will definitely look at that.
Yes, hips osteopenic and only just in osteoporosis for spine so that's why I'm going to try HRT alongside the diet and exercise etc to try and avoid anything getting worse. I'm way past meno now at 52 (about 44/45 I think, but as I had a resection of the endometrium I can't be sure exactly) but it seems ok if you are under 60 doesn't it?
I don't know why GP suggests AA first as BMS says it should be used with caution in women under 60.
Good tip about jogging bursts in walk - I'll give that a go, plus weights. :)
Are you getting on ok with the patch? Not sure whether to ask for gel or that.
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Thanks for the info Stockport - just seen your pm - I will definitely look at that.
Yes, hips osteopenic and only just in osteoporosis for spine so that's why I'm going to try HRT alongside the diet and exercise etc to try and avoid anything getting worse. I'm way past meno now at 52 (about 44/45 I think, but as I had a resection of the endometrium I can't be sure exactly) but it seems ok if you are under 60 doesn't it?
I don't know why GP suggests AA first as BMS says it should be used with caution in women under 60.
Good tip about jogging bursts in walk - I'll give that a go, plus weights. :)
Are you getting on ok with the patch? Not sure whether to ask for gel or that.
The local bone unit instructs GPs around here to use AA. The word on the street is that it's the cheapest option so should be tried first.
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Are you getting on ok with the patch? Not sure whether to ask for gel or that.
I have had some breakthrough bleeding but apart from that I don't even know I am using HRT.