Bioidentical hormones for osteoporosis

Posted by vkmov @vkmov, Nov 23, 2023

Has anyone had good or bad experiences taking bioidentical hormones for osteoporosis? I’ve used the lowest dose of transdermal hormones which helped but now have a higher risk and need to make a decision about Forteo or finding a bioidentical hormone specialist who will increase the dose. I’m 74.

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@kisu

I'm unclear on your question. Are you asking, can I use an estrogen cream on my inner labia and expect this to keep my bones healthy? The answer is positively no.
I have more questions for you than answers.

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I do agree that the HRT needs to be systemic to help maintain my bone density. I asked my rheumatologist this morning what she thought and she’d like to see me go on Reclast but thought HRT would at least keep my gains. I’d love to stay on Tymlos for a bit longer but the likelihood of insurance continuing to cover it after 2 years is highly unlikely. Let me know if I have any questions or wisdom to share as I prepare the this next phase of meds. Thanks

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@dooshie

I do agree that the HRT needs to be systemic to help maintain my bone density. I asked my rheumatologist this morning what she thought and she’d like to see me go on Reclast but thought HRT would at least keep my gains. I’d love to stay on Tymlos for a bit longer but the likelihood of insurance continuing to cover it after 2 years is highly unlikely. Let me know if I have any questions or wisdom to share as I prepare the this next phase of meds. Thanks

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Hi @dooshie is tymlos approved for more than 2 years? Even so, do you have your btms tested to see if it’s still working?

Did your rheumatologist plan to have you get Reclast and HRT at the same time?

Thanks a lot!

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@mayblin

Hi @dooshie is tymlos approved for more than 2 years? Even so, do you have your btms tested to see if it’s still working?

Did your rheumatologist plan to have you get Reclast and HRT at the same time?

Thanks a lot!

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No, Tymlos is not approved for longer than 2 years although, I have read on a couple of support sites that some women have taken it longer. My doc says insurance will likely not cover it after the 2 years.
We are still considering the options after I finish Tymlos. She’d like me on Reclast and says most of her patients tolerate it well. And, we didn’t discuss taking Reclast with HRT’s. Didn’t even think to ask. I’ll be discussing all of this with both my cardiologist and rheumatologist in the next month.

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An interesting study on Science Direct, titled "The effect of transvaginal estradiol on bone in aged women: a randomissed controlled trial." https://www.sciencedirect.com/science/article/abs/pii/S0378512207001259#:~:text=Results,control%20group%20increased%20by%202.2%25.

It's a 2007 study conducted on 70+ women showing BMD improvements. My own history suggests it worked on me as well. I had my largest, fastest BMD increase the year I used transvaginal estradiol.

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@mlwh

An interesting study on Science Direct, titled "The effect of transvaginal estradiol on bone in aged women: a randomissed controlled trial." https://www.sciencedirect.com/science/article/abs/pii/S0378512207001259#:~:text=Results,control%20group%20increased%20by%202.2%25.

It's a 2007 study conducted on 70+ women showing BMD improvements. My own history suggests it worked on me as well. I had my largest, fastest BMD increase the year I used transvaginal estradiol.

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That is not an option for hormone positive breast cancer patients.

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@dooshie

No, Tymlos is not approved for longer than 2 years although, I have read on a couple of support sites that some women have taken it longer. My doc says insurance will likely not cover it after the 2 years.
We are still considering the options after I finish Tymlos. She’d like me on Reclast and says most of her patients tolerate it well. And, we didn’t discuss taking Reclast with HRT’s. Didn’t even think to ask. I’ll be discussing all of this with both my cardiologist and rheumatologist in the next month.

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I misread your comment. No I don't think they add values when taken together. I'm actively exploring options including HRT after forteo completion as well. If we both choose HRT, let's compare notes if you feel like!

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Hi, was searching online for CLL individuals and the safest route to take. A response from AI Open Evidence on HRT;
https://www.openevidence.com/ask/230443ea-588f-4de0-963b-20c3f4dab8a0

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@mlwh

An interesting study on Science Direct, titled "The effect of transvaginal estradiol on bone in aged women: a randomissed controlled trial." https://www.sciencedirect.com/science/article/abs/pii/S0378512207001259#:~:text=Results,control%20group%20increased%20by%202.2%25.

It's a 2007 study conducted on 70+ women showing BMD improvements. My own history suggests it worked on me as well. I had my largest, fastest BMD increase the year I used transvaginal estradiol.

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It just goes to show every person is different. I have been using vaginal estradiol cream (inserted in the vagina and outer) from age 59 to 74. To renew my yearly RX prescription, hormone blood tests were required. The blood work included estradiol serum, progesterone/pregnenolone serum (< - test is questionable since I don't have a uterus), estrone serum , testosterone, DHEA, and estriol serum. Each year without exception my postmenopausal estradiol levels were so low they were undetectable. Maybe I'm an outlier? My testosterone, estrone, and DHA all had detectable amounts.
After reading the randomized trial I'm feeling confused. Soon I'll be using a .05 mg transdermal patch which is still considered on the low side. The trial used a vaginal 7.5ug, which is 40 times less than .05mg. 7.5ug is 17.5 times less than the lowest transdermal estradiol .025 patch. Should I conclude that vaginal estradiol is the superior absorption delivery method?
I am happy you had good results mlwh 🙂

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@mlwh

An interesting study on Science Direct, titled "The effect of transvaginal estradiol on bone in aged women: a randomissed controlled trial." https://www.sciencedirect.com/science/article/abs/pii/S0378512207001259#:~:text=Results,control%20group%20increased%20by%202.2%25.

It's a 2007 study conducted on 70+ women showing BMD improvements. My own history suggests it worked on me as well. I had my largest, fastest BMD increase the year I used transvaginal estradiol.

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Were you on any osteo medication or just HRT? Was the estradiol the only thing you were doing, was it a suppository and was it bioidentical or synthetic? This is really interesting information. How much improvement did u have on ur BMD? Thank you

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@thora902

That is not an option for hormone positive breast cancer patients.

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A friend told me about Bioidentical hormone therapy. Said it was safe. I have followed up on this therapy - are you hearing it is safe for breast cancer survivors? I had a Mastectomy 4 1/2 yrs ago. No chrmo, no radiation and Anastrozole I took for 2 1/2 yrs before quitting due to side effect of terrible hip pain.

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