What would you do? Medication.

When you say you "follow Dr. Doug Lucas," do you mean by reading and watching his videos or do you participate in one of his programs? Thanks.

I had a mountain bike accident five years ago. I was going down a steep slope at a fast pace, and my front wheel slid sideways into a rut. I reflexively grabbed both brakes and got launched over the handlebars. I probably traveled 10 feet through the air, and dropped at least 8 feet onto hard-packed dirt and rock. The impact was violent, and it fractured my pelvis in two places. Search and Rescue had to come get me, I was out in the middle of nowhere. But, three weeks later, I walked away, whistling, all healed. It was like it had never even happened! No pain since. And the ER doc and the orthopedist said, "Man, you must have strong bones!" So, I tucked away the idea of a DEXA, having been bucked off horses, fallen out of trees, you name it. I never smoked, drank very little alcohol, didn't drink soda, no stomach problems, one cup of coffee a day, ate cheese, yogurt, tofu, drank milk, and ran thousands of miles training for marathons. Took karate, did yoga, played every sport and was just very active in general. I even went through a period in my 20s where I ate lots of sardines on crackers!
My mother is 92, and she played tennis until she was 80. She fractured her ankle getting out of her hot tub 2 years ago, and the surgeon said she had great bones.

Fast forward to Jan 15th, 2024. Went out to ski a few runs with my husband (we live at Lake Tahoe). On the first run, I got caught on my outside ski edge and was headed toward some fencing. In order to stop, I simply sat down. Immediately got back up and skied away. No pain, nothing. But in the next few runs, something wasn't quite right. My legs felt weak, and I was having trouble controlling my skis. I thought I was just having a bad day. I do squats and lunges to keep my legs strong, for skiing, so it was a little strange. Nothing more for a week, but then mid back started feeling tight, then went into massive spasms. The pain was so intense, worsening when I tried to lie down. I got no sleep at all. I had never had back trouble, so I was mystified.

Long story short, I went to work (I'm a physician at a university student health clinic) and got diagnosed with an L1 compression fracture. Subsequently had a DEXA which showed osteoporosis in both spine and hips, spine the worst w/ T score -2.8, and left hip -2.6. I can't begin to tell you what an insane surprise this was. I sat in my car after the DEXA trying to digest the results. My husband doesn't believe it, and my little brother was incredulous. They've seen me just thrash myself for years.
I alternate between feeling depressed (I went skiing and turned into a decrepit little old lady) and feeling searing rage at the universe (how dare this happen when I have tried to live a healthy life).

I started piecing things together. My only real risk factors are being a slender blonde, and stopping hormones when the Women's Health Initiative suggested it wasn't a good idea to continue them after menopausal symptoms stopped. Well, well, well, the Women's Health Initiative, who served up a big kettle of bullshit stew, and the medical world lapped it up. Never mind that the findings were totally debunked later, it was that sensational headline: "Estrogen in menopause causes breast cancer, heart disease and dementia!" was blasted across the front pages of newspapers around the world. Had we all lost our minds? Something that courses through your body from the onset of menses to menopause is suddenly a deadly poison? But it was taken to heart by the medical profession, and most people never bothered to check further.
For an interesting book about how much we need estrogen, check out "Estrogen Matters" by oncologist Avrum Bluming, MD and psychologist Carol Tavris. They go over in detail the link between estrogen and breast cancer (there isn't one) and how much women need estrogen to live long healthy lives and most importantly, keep their skeletons strong.
The difference between my 92 y/o mother and I? She had her uterus yanked out (didn't everybody's mom have that back then?) and was PUT ON ESTROGEN and took it for years. I had it for 2 years and then stopped because of the good ol' Women's Health initiative misinformation.
I attempted to restart it about a year ago because I was having a drop in my sex drive and experiencing "vaginal dryness." That's a euphemism for actually feeling like your vagina was sanded down with a Brillo pad and then finished off by a blow torch after having sex. When I mentioned restarting it to the young male gynecologist I saw for a Pap smear (my older doctor had retired), he was alarmed. "No, " he said, "I've seen too many cases of cancer!" and then, unbelievably, followed that with, "If you're having a drop in your libido, maybe you should see a sex therapist." I was too stunned to reply. I've been sleeping with the same guy for 40 years; I think we have it dialed in by now.
Part of me wonders about how older women are perceived, it's like, you old harpy, your child-bearing days are over, why would you even need to have sex? Meanwhile, there are pills, pumps, creams and injections all to help men achieve erections. But women? Just be quiet and cook dinner, then go fall off a cliff, why dontcha?

Anyway, sorry for the long rant. I just want to say that we should be open to anything in terms of helping our bones. I am now on a full dose of estrogen and progesterone, taking Evista because I couldn't wait to start something, and the osteoporosis specialist I saw is getting Tymlos for me, because unlike Forteo, it doesn't have to be refrigerated. Both those drugs are anabolic; they build bone. Then I will take something like a bisphosphonate to maintain my newly built bones. My kitchen counter is littered with many types of calcium supplements and Vitamin D3 with K2, but that's not new. I have been taking BoneUp, and vitamin D3 for years, not that it seems to have done much good. And I can't tell you how many docs I have seen over the past 20 years for this or that, including Paps and preventative visits and not ONE ever suggested that I needed a DEXA scan. A slender blonde, who was resting on her laurels because she had no family history and a rough and tumble past. So I can blame myself, too.

I had a mountain bike accident five years ago. I was going down a steep slope at a fast pace, and my front wheel slid sideways into a rut. I reflexively grabbed both brakes and got launched over the handlebars. I probably traveled 10 feet through the air, and dropped at least 8 feet onto hard-packed dirt and rock. The impact was violent, and it fractured my pelvis in two places. Search and Rescue had to come get me, I was out in the middle of nowhere. But, three weeks later, I walked away, whistling, all healed. It was like it had never even happened! No pain since. And the ER doc and the orthopedist said, "Man, you must have strong bones!" So, I tucked away the idea of a DEXA, having been bucked off horses, fallen out of trees, you name it. I never smoked, drank very little alcohol, didn't drink soda, no stomach problems, one cup of coffee a day, ate cheese, yogurt, tofu, drank milk, and ran thousands of miles training for marathons. Took karate, did yoga, played every sport and was just very active in general. I even went through a period in my 20s where I ate lots of sardines on crackers!
My mother is 92, and she played tennis until she was 80. She fractured her ankle getting out of her hot tub 2 years ago, and the surgeon said she had great bones.

Fast forward to Jan 15th, 2024. Went out to ski a few runs with my husband (we live at Lake Tahoe). On the first run, I got caught on my outside ski edge and was headed toward some fencing. In order to stop, I simply sat down. Immediately got back up and skied away. No pain, nothing. But in the next few runs, something wasn't quite right. My legs felt weak, and I was having trouble controlling my skis. I thought I was just having a bad day. I do squats and lunges to keep my legs strong, for skiing, so it was a little strange. Nothing more for a week, but then mid back started feeling tight, then went into massive spasms. The pain was so intense, worsening when I tried to lie down. I got no sleep at all. I had never had back trouble, so I was mystified.

Long story short, I went to work (I'm a physician at a university student health clinic) and got diagnosed with an L1 compression fracture. Subsequently had a DEXA which showed osteoporosis in both spine and hips, spine the worst w/ T score -2.8, and left hip -2.6. I can't begin to tell you what an insane surprise this was. I sat in my car after the DEXA trying to digest the results. My husband doesn't believe it, and my little brother was incredulous. They've seen me just thrash myself for years.
I alternate between feeling depressed (I went skiing and turned into a decrepit little old lady) and feeling searing rage at the universe (how dare this happen when I have tried to live a healthy life).

I started piecing things together. My only real risk factors are being a slender blonde, and stopping hormones when the Women's Health Initiative suggested it wasn't a good idea to continue them after menopausal symptoms stopped. Well, well, well, the Women's Health Initiative, who served up a big kettle of bullshit stew, and the medical world lapped it up. Never mind that the findings were totally debunked later, it was that sensational headline: "Estrogen in menopause causes breast cancer, heart disease and dementia!" was blasted across the front pages of newspapers around the world. Had we all lost our minds? Something that courses through your body from the onset of menses to menopause is suddenly a deadly poison? But it was taken to heart by the medical profession, and most people never bothered to check further.
For an interesting book about how much we need estrogen, check out "Estrogen Matters" by oncologist Avrum Bluming, MD and psychologist Carol Tavris. They go over in detail the link between estrogen and breast cancer (there isn't one) and how much women need estrogen to live long healthy lives and most importantly, keep their skeletons strong.
The difference between my 92 y/o mother and I? She had her uterus yanked out (didn't everybody's mom have that back then?) and was PUT ON ESTROGEN and took it for years. I had it for 2 years and then stopped because of the good ol' Women's Health initiative misinformation.
I attempted to restart it about a year ago because I was having a drop in my sex drive and experiencing "vaginal dryness." That's a euphemism for actually feeling like your vagina was sanded down with a Brillo pad and then finished off by a blow torch after having sex. When I mentioned restarting it to the young male gynecologist I saw for a Pap smear (my older doctor had retired), he was alarmed. "No, " he said, "I've seen too many cases of cancer!" and then, unbelievably, followed that with, "If you're having a drop in your libido, maybe you should see a sex therapist." I was too stunned to reply. I've been sleeping with the same guy for 40 years; I think we have it dialed in by now.
Part of me wonders about how older women are perceived, it's like, you old harpy, your child-bearing days are over, why would you even need to have sex? Meanwhile, there are pills, pumps, creams and injections all to help men achieve erections. But women? Just be quiet and cook dinner, then go fall off a cliff, why dontcha?

Anyway, sorry for the long rant. I just want to say that we should be open to anything in terms of helping our bones. I am now on a full dose of estrogen and progesterone, taking Evista because I couldn't wait to start something, and the osteoporosis specialist I saw is getting Tymlos for me, because unlike Forteo, it doesn't have to be refrigerated. Both those drugs are anabolic; they build bone. Then I will take something like a bisphosphonate to maintain my newly built bones. My kitchen counter is littered with many types of calcium supplements and Vitamin D3 with K2, but that's not new. I have been taking BoneUp, and vitamin D3 for years, not that it seems to have done much good. And I can't tell you how many docs I have seen over the past 20 years for this or that, including Paps and preventative visits and not ONE ever suggested that I needed a DEXA scan. A slender blonde, who was resting on her laurels because she had no family history and a rough and tumble past. So I can blame myself, too.

I had a mountain bike accident five years ago. I was going down a steep slope at a fast pace, and my front wheel slid sideways into a rut. I reflexively grabbed both brakes and got launched over the handlebars. I probably traveled 10 feet through the air, and dropped at least 8 feet onto hard-packed dirt and rock. The impact was violent, and it fractured my pelvis in two places. Search and Rescue had to come get me, I was out in the middle of nowhere. But, three weeks later, I walked away, whistling, all healed. It was like it had never even happened! No pain since. And the ER doc and the orthopedist said, "Man, you must have strong bones!" So, I tucked away the idea of a DEXA, having been bucked off horses, fallen out of trees, you name it. I never smoked, drank very little alcohol, didn't drink soda, no stomach problems, one cup of coffee a day, ate cheese, yogurt, tofu, drank milk, and ran thousands of miles training for marathons. Took karate, did yoga, played every sport and was just very active in general. I even went through a period in my 20s where I ate lots of sardines on crackers!
My mother is 92, and she played tennis until she was 80. She fractured her ankle getting out of her hot tub 2 years ago, and the surgeon said she had great bones.

Fast forward to Jan 15th, 2024. Went out to ski a few runs with my husband (we live at Lake Tahoe). On the first run, I got caught on my outside ski edge and was headed toward some fencing. In order to stop, I simply sat down. Immediately got back up and skied away. No pain, nothing. But in the next few runs, something wasn't quite right. My legs felt weak, and I was having trouble controlling my skis. I thought I was just having a bad day. I do squats and lunges to keep my legs strong, for skiing, so it was a little strange. Nothing more for a week, but then mid back started feeling tight, then went into massive spasms. The pain was so intense, worsening when I tried to lie down. I got no sleep at all. I had never had back trouble, so I was mystified.

Long story short, I went to work (I'm a physician at a university student health clinic) and got diagnosed with an L1 compression fracture. Subsequently had a DEXA which showed osteoporosis in both spine and hips, spine the worst w/ T score -2.8, and left hip -2.6. I can't begin to tell you what an insane surprise this was. I sat in my car after the DEXA trying to digest the results. My husband doesn't believe it, and my little brother was incredulous. They've seen me just thrash myself for years.
I alternate between feeling depressed (I went skiing and turned into a decrepit little old lady) and feeling searing rage at the universe (how dare this happen when I have tried to live a healthy life).

I started piecing things together. My only real risk factors are being a slender blonde, and stopping hormones when the Women's Health Initiative suggested it wasn't a good idea to continue them after menopausal symptoms stopped. Well, well, well, the Women's Health Initiative, who served up a big kettle of bullshit stew, and the medical world lapped it up. Never mind that the findings were totally debunked later, it was that sensational headline: "Estrogen in menopause causes breast cancer, heart disease and dementia!" was blasted across the front pages of newspapers around the world. Had we all lost our minds? Something that courses through your body from the onset of menses to menopause is suddenly a deadly poison? But it was taken to heart by the medical profession, and most people never bothered to check further.
For an interesting book about how much we need estrogen, check out "Estrogen Matters" by oncologist Avrum Bluming, MD and psychologist Carol Tavris. They go over in detail the link between estrogen and breast cancer (there isn't one) and how much women need estrogen to live long healthy lives and most importantly, keep their skeletons strong.
The difference between my 92 y/o mother and I? She had her uterus yanked out (didn't everybody's mom have that back then?) and was PUT ON ESTROGEN and took it for years. I had it for 2 years and then stopped because of the good ol' Women's Health initiative misinformation.
I attempted to restart it about a year ago because I was having a drop in my sex drive and experiencing "vaginal dryness." That's a euphemism for actually feeling like your vagina was sanded down with a Brillo pad and then finished off by a blow torch after having sex. When I mentioned restarting it to the young male gynecologist I saw for a Pap smear (my older doctor had retired), he was alarmed. "No, " he said, "I've seen too many cases of cancer!" and then, unbelievably, followed that with, "If you're having a drop in your libido, maybe you should see a sex therapist." I was too stunned to reply. I've been sleeping with the same guy for 40 years; I think we have it dialed in by now.
Part of me wonders about how older women are perceived, it's like, you old harpy, your child-bearing days are over, why would you even need to have sex? Meanwhile, there are pills, pumps, creams and injections all to help men achieve erections. But women? Just be quiet and cook dinner, then go fall off a cliff, why dontcha?

Anyway, sorry for the long rant. I just want to say that we should be open to anything in terms of helping our bones. I am now on a full dose of estrogen and progesterone, taking Evista because I couldn't wait to start something, and the osteoporosis specialist I saw is getting Tymlos for me, because unlike Forteo, it doesn't have to be refrigerated. Both those drugs are anabolic; they build bone. Then I will take something like a bisphosphonate to maintain my newly built bones. My kitchen counter is littered with many types of calcium supplements and Vitamin D3 with K2, but that's not new. I have been taking BoneUp, and vitamin D3 for years, not that it seems to have done much good. And I can't tell you how many docs I have seen over the past 20 years for this or that, including Paps and preventative visits and not ONE ever suggested that I needed a DEXA scan. A slender blonde, who was resting on her laurels because she had no family history and a rough and tumble past. So I can blame myself, too.

May I ask a few questions to clarify my understanding of your current treatment choices? On top of estrogen and progesterone, are you currently on Evista also? If so, why? Also whats your estrogen and progeterone dosages if you dont mind sharing? After your tymlos' approval, will you be taking hormones together with tymlos? Why and why not?

Personally I think for those of us who have osteoporosis due to estrogen deficiency, transdermal hrt is a great choice if no contraindications exist. The shifting sentiments towards hrt are palpable. I'm waiting for my clearance.

Accidents happen. If you are that active, it might be a good idea to wind down a bit as you age. With a same t score, the frax risk is higher for a 70yo compared to a 60yo. Severity of impact matters too. One of my childhood friends has good dexa readings (t score at ~ -1s) but had a freaking accident on ice. Her left tibia was broken into pieces. I had slipped at home landing on my back and head 3 years before my dx but was fine. I'm not sure I could say the same should I have the same accident today. Sometimes how we fall also matters, but that's out of our control. Fall prevention is still a top priority. Spine compression fracture may be another story.

Wish you the best!

@glojo, I'm right there with you. When I started this thread one month ago, I referenced a few fracture-less falls I'd taken while preparing for a long hike that I completed in September (diagnosed in October). Those falls made me wonder about my actual bone health despite my low DXA hip score and, further, if I could somehow impair good bone by taking medicine if I really don't need it due to good bone quality. I participated in an excellent webinar yesterday with Debi Robinson (Bone Health Expert, Certified Yoga Therapist C-IAYT, Certified Health Coach FDN-P at Functional Diagnostic Nutrition®). She referenced my body size indicating that smaller framed people are likely to come up with low DXA scores. So I DO feel extremely lucky and the fall DID increase the faith I have in my bones. At the same time, I don't want to be stupid about this because once you fracture, troubles compound. My most recent idea is to fly to CA to see an integrative medicine specialist (Kim Millman, MD) so I can get both perspectives (natural remedies + meds if necessary). I've been all over the place in my thinking, as many of us have. I'm so glad I have taken time to educate myself, and to narrow down the list of people I follow and whose opinions I trust.

I think twisting and contorting are more of a risk than falls, from my personal experience. And opening windows, bending over to lift things, etc. Excessive weight too.

So sorry to hear about your fall, but isn’t it strange how that plays with our heads. I took a bad fall a year ago, slipping on a surprise patch of mud and goose poop on a lake trail. My feet flew out from underneath me like a comedy banana peel routine. I landed flat on my -3.7 T score back and banged my head. After assuming I would now crumble and my life would be forever changed, I got up and walked a half mile to my car…filthy but in one piece. Suffered incredibly painful glutes for a few weeks but that was it. So do we look at these near misses as better indicators of bone health than a standard deviation from a 30 year old, or do we just feel lucky, or both? I’m not smugly saying this is wise, but it did make me hesitate even more before starting medications that might make me feel icky enough to not workout, which is likely what strengthened my glutes enough that they fired up and protected my lumbar?! Throw the dice!