Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Cassie on September 19, 2024, 12:26:05 PM
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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.
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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
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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
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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?
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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?
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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!
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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.
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Do have a word with her about tibolone or even raloxifene.
I wouldn't touch bisphosphonates either but going completely untreated is madness.
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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!
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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.
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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 ;D 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.
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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.
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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
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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.
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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?
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Cassie, I thought they used pg/mL in the US which would be about 220 pmol. That still sounds slightly low because it should be above 250.
This is from the late Professor Studd who really knew his stuff:
https://www.studd.co.uk/osteo_oestro.php
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US uses different measurement units.
Really for optimal osteoporosis prevention or treatment you want over 450pmol or over 100 in US units.
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One thing I would add is that bone density and bone quality are two different things. You can further help yourself by ensuring you get enough boron, magnesium, vit K, iron, vit D and calcium. There is a lot of research to suggest that collagen and turmeric help with bone density. The irony is that many fractures occour among the population with 'normal' bone density.
I would not touch bisphosphonates as the mechanism 'holds onto' the poor quality bone which would normally be jettisoned. It increases the density but by keeping poor quality bone. You need something anabolic which encourages new bone. If you take the drugs at all. There are many things you can do including the HRT to improve your numbers. You can have high quality less dense bones which won't break.
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WOW we are a Mine of Info on here :thankyou:
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Thank you girls, really appreciate this so much.
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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?
I'm also against them. The stop your osteoclasts working. These chew the old bone. Bisphosphonates put new bone down on old weak bones. Think building an extension on bad footings.
I don't think that's true about the jaw bone for OP.
While walking is good, resistance training is more important
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Any example of easy training apart from walking I can do at home? Would that be doing up steps down steps that sort or thing or walking with a weight :-\
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I think you are all very brave in deciding not to take prescribed medication for your osteoporosis.
I don't want to be a Debbie Downer but honestly, having watched my mum and her sister's deterioration over the decades with this condition I seriously wouldn't take any chances. It isn't just about having a bit of a humped back, it affects so much more, especially if you experience spontaneous crush fractures of the spine as my mum did.
Anyway enough said. Good luck with whatever you decide to do.
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JillyBoo BHRT is really beneficial and I plan to up that with the assistance of my Dr and hopefully with exercise & diet keep things from progressing, it can be done.
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There are some excellent books out there - Osteoporosis Reversal Secrets - Igor Klibanov; The Osteoporosis Breakthrough - Doug Lucas and many more. Don't just follow one, do your research and put together a plan to help yourself. If you do take the drugs make sure you get the anabolic ones. The only reason bisphosphonates are so widely prescribed is that they are much cheaper. My endo told me that. And there was a class action resulting in the main one carrying serious warnings.
Re exercise - there is no substitute for high impact - walking may maintain bone but it will not increase density. Running jumping stamping etc. That is really what you need. And weights.
HRT used to be the go to treatment for bone loss - much safer.
What were your numbers? None of us get a baseline number and if we are small/light we have lower bone density. The standard we are measured against is a much bigger 'average' woman and the DXA scans convert 2D images into 3D so bigger bones higher density!
The research is all out there to support this. As a trained medical lawyer I am very familiar with the lawsuits relating to pharma.
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Jillyboo could I post my numbers as I really dont understand them but it will be a while before I see the Dr so would be happy if someone knows how to interpret them.
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I think you are all very brave in deciding not to take prescribed medication for your osteoporosis.
I don't want to be a Debbie Downer but honestly, having watched my mum and her sister's deterioration over the decades with this condition I seriously wouldn't take any chances. It isn't just about having a bit of a humped back, it affects so much more, especially if you experience spontaneous crush fractures of the spine as my mum did.
Anyway enough said. Good luck with whatever you decide to do.
HRT used to be the gold standard. Bisphosphonates are awful things. They stop osteoclasts chewing old bone and put new on top of old. Think a really bad extension being built on bad footings. Plus, you cannot take for any longer than 5 years as they will then cause fractures. With a low frax score they really don't do much good.
https://www.nice.org.uk/guidance/ta464/resources/bisphosphonates-for-treating-osteoporosis-patient-decision-aid-pdf-6896787085#:~:text=Treatment%20with%20a%20bisphosphonate%20reduces,fracturing%20your%20wrist%20or%20arm.
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Jillyboo could I post my numbers as I really dont understand them but it will be a while before I see the Dr so would be happy if someone knows how to interpret them.
Post them & maybe we can help :)
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Thankyou, its all jargon to me, I just know I need to try and get my spine number improved :-\
Thoracic Spine no insuffiency fracture identified.
Lumbar Spine T -score of -2.9
Dual Femur left & right hips have T scores of -2.2 and -2.3 falling in the oseopenic range
A T score of -2.5 in the right femoral neck indicates focal osteoporosis.
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Thankyou, its all jargon to me, I just know I need to try and get my spine number improved :-\
Thoracic Spine no insuffiency fracture identified.
Lumbar Spine T -score of -2.9
Dual Femur left & right hips have T scores of -2.2 and -2.3 falling in the oseopenic range
A T score of -2.5 in the right femoral neck indicates focal osteoporosis.
Can I ask your age?
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59 ;D
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Thankyou, its all jargon to me, I just know I need to try and get my spine number improved :-\
Thoracic Spine no insuffiency fracture identified.
Lumbar Spine T -score of -2.9
Dual Femur left & right hips have T scores of -2.2 and -2.3 falling in the oseopenic range
A T score of -2.5 in the right femoral neck indicates focal osteoporosis.
It looks like you are in the osteoporosis range for spine and osteopenia for hips.
You lose most of your bone density in the first years after meno.
Weight bearing exercise. Weights!
Vitamin K2 &D3 (ideally these should be gel tabs as they are fat soluble)
Increase calcium by food (calcium tabs are chalk). Add chia/pumpkin/sunflower seeds. Lots of veg.
If you like I can give you a great fb group for OP (that do not take drugs, just HRT)
My bone density increased in 1 year after taking HRT
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Thank you so much, yes please, can you refer me to the group. Am def going to focus on the HRT & supplements. I am so confused re weight does that mean I have to start lifting weights ;D or just walking and stomping hard on the ground? Have read about things like heel drops steps etc but its all so overwhelming....
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Skip Girl Skip ;). Brisk walking: fast enough to be able to talk to a friend without panting. Apparently ::). Also remember that the bone in the jaw needs activity to keep it healthy and to stop gums receding.
New option for treating osteoporosis after menopause - British Menopause Society ......... 2024. Via MM. Too tired to copy the item.
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Thank you so much, yes please, can you refer me to the group. Am def going to focus on the HRT & supplements. I am so confused re weight does that mean I have to start lifting weights ;D or just walking and stomping hard on the ground? Have read about things like heel drops steps etc but its all so overwhelming....
Yes you need to do weights. You can start light, I started with 1kg & now use 5 or 10kg
Heel drops are great, been scientifically proven.
If you walk, take a rucksack with something in it.
Have a look at fabulous 50's & pahla b for exercise on YouTube
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Skip Girl Skip ;).
But don't trip over the rope & fall😆
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Oh gosh now that would be a sight for sore eyes ;D