What would you do? Medication.

That was my hurdle too. It’s been over 10 months since I learned of my big drop in bone density (since my initial decline after menopause 15 years ago) and I’m just now coming to terms with my next steps.

I managed well without medications for years, but now with a -3.1 lumbar spine and -2.7 hip and as a downhill skier (and cross country, backcountry skier), I feel I need to shore-up my bones with an anabolic and lock-in the gains with a bisphosamate now, so I can continue doing my sports with less fear. Hopefully, I won’t need anymore medications for another 10-15 years🤞

Keith McCormick was not a post-menopausal female. Personally, I am not using his story as a model for myself.

Tymlos is another anabolic that works well for spine.

You bring up an interesting question, @windyshores. We are encouraged to find the root cause of the problem, and that makes sense to me when someone has a condition such as hyperparathyroidism - or maybe someone took chemo or was on corticossteroid for a long time. I suspect I have it because of menopause and the havoc that can cause. I was diagnosed with a blood clot in college (not sure how accurate that was) so HRT was not an option for me. Menopause can't be "fixed" so what is there to do, really? It seems like the choice for us is meds or no meds depending on the T score and fractures (or not). Am I missing anything there?

Also, do you know why they use the T score as a reference point vs. the Z score which compares us with similarly aged peers instead of 30 year olds?

Thanks!

https://www.healthline.com/health/t-score-vs-z-score-osteoporosis#summary
"Which is more accurate, a t-score or a z-score?
Both scores are considered accurate, but they’re used for different purposes. T-scores can be used to diagnose osteopenia and osteoporosis, while z-scores can help diagnose secondary osteoporosis."

I guess I don't know what secondary osteoporosis is - OP caused by some other factor than the passage of time?

@babs10 https://www.healthline.com/health/managing-osteoporosis/secondary-osteoporosis#causes

What causes secondary osteoporosis?
Secondary osteoporosis may be caused by certain health conditions, drugs, or lifestyle factors. Common causes include health issues such as:

diabetes
hyperthyroidism
hypogonadism
chronic kidney disease
celiac disease
chronic liver diseaseTrusted Source
inflammatory bowel disease
eating disorders
cancer
bone-marrow-related disorders
gastrointestinal disorders
organ transplantation
Other causes
In addition to health conditions, there are many other things that may affect your bones and lead to osteoporosis, such as:

Medications
Drugs that raise the risk of osteoporosis include:

steroids such as:
corticosteroids
glucocorticoids
hormone treatments such as:
thyroid hormone
medroxyprogesterone
mood disorder treatments such as:
selective serotonin reuptake inhibitors (SSRIs)
lithium
seizure treatments such as:
carbamazepine
phenytoin
Drugs to prevent organ transplant rejection, such as:
cyclosporine
tacrolimus
Other medications such as:
antiretroviral therapy
heparin
furosemide
proton pump inhibitors

Wow, that's quite a list. This brings me back around to the first part of my previous post. Some of the more holistic practitioners suggest a lot of blood tests to help them get to the root of the diagnosis. If there are no mitigating factors besides menopause, is that the root cause? Thanks.

I personally don't get into other causes, though cancer meds certainly worsened my osteoporosis. But menopause caused a big drop before that. PTH (parathyroid) is one factor I think would be good to check.

Again my personal view is that if a woman is past menopause. doing all those alternative tests might be a waste of money. But it depends on T scores. If osteoporosis is mild there might be other approaches besides meds that can mitigate bone loss, even if menopause is the cause!

@babs10 and @lynn59 I missed the good discussion this morning. I have to agree with windyshore: we have to remember K Mccormick is a man. He did forteo then follwed by ~1 year fosamax then no pharmaceuticals. This is not likely to be reproducible by an average menopausal woman. If we search online and compare the bone loss between men and women, we'd see a stark difference in terms of the rate of the loss as well as the onset of loss as we age.

Aside from secondary etiology (certain disease states, certain drug-induced as listed by windyshores), most women with osteoporosis got it due to the drop in estrogen levels during menopause unfortunately. One can get a battery of tests to rule out many secondary causes. But on average, the culprit is likely estrogen. Once a while we hear people improve to osteopenia range without meds, but those are far and in between. I wish I could be one of them countless time but then I figured it's not likely, for me at least.

Not trying to be negative. Just a word of caution maybe. Let's keep vigilant, watch out for our bones. Best luck to everyone on this journey.

I agree with what both of you have said. I've had the standard tests run, and am reluctant to do much more ($$$) because I really do think I have OP due to menopause and I have to play the hand I was dealt. Interesting discussion though. Thanks for weighing in.