Is hrt a good option after Evenity

Hi @gravity3 what is your endo’s opinion regarding this? Was the cause of your osteoporosis mainly a result of estrogen difficiency? Have you consulted with your cardiologist or obgyn for the late start of HRT?

I should have mentioned that my primary reason for considering hrt at my age was to increase energy, libido, ability to increase muscle and help with sleep. I am concerned that three providers could not seem to consider hrt and did not seem to be able to discuss the current thinking about the flawed women's health initiative study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331845/

I see an integrative gynecologist, Dr Felice Gersh, who is very knowledgeable and experienced on prescribing and dosing hormones. She has been doing it for decades. She strongly advises against the use of pellets as they are difficult to dose correctly and they are in your body for several months. She has seen many patients who have been overdosed on them. As a side note, a friend of mine used testosterone pellets and lost a lot of hair, a known side effect of too high a dose. The article sited above is by the founder of BioTE pellets so is likely biased in his perspective. If you choose to use testosterone and other hormones, transdermal seems to be the safest method.

Thank you.

The current preferred HRT prescribed by many physicians appears to be transdermal estradiol plus oral micronized progesterone if the uterus is intact. The preferred starting time is within 10 years post menopause with exceptions. The presenter in this video talked about HRT usage in the management of osteopenia/osteoporosis:

Please keep us posted regarding your endeavors in using HRT, and whether or not you will use bone markers to monitor progress.

All the best!

I was on bioidentical hormone crème for 20 years with good results for menopause…no symptoms. I went on pellet therapy 8 months ago on a low dose…there are 10 levels. My integrative medicine dr does bloodwork every three months. I am doing this for my bones but I have to say I feel more mental clarity and energy. I will post my dexa results in Feb. I will not go on a higher dose. Now I am on 67 and the average dosing is 100. My blood levels are good at this time. If you choose this path please use a reputable integrative medical doctor with a lot of experience. Dr Erika Swartz in NYC is an expert in the field. In Philadelphia De Anthony Bazzan at Jefferson is excellent. Both are published and highly regarded. One thing to keep in mind is that big pharma gets nothing from bioidentical hormones so it is not approved. $$$$

Thank you so much. Would love to hear more as you continue your bone journey. A wonderful wealth of information here

I don't know the cost of pellet therapy as it's not something I would consider but the HRT you get through your pharmacy is bioidentical and very inexpensive. I believe it is not an "approved" drug for osteoporosis but it is for menopausal symptoms so you can get coverage under that diagnosis. If you can't get it approved and you live in the states, you can always go through Alloy Health online. They have MDs on staff that will review your case and make recommendations. I believe the initial consult is free. You can then order your HRT through them if you decide to proceed. The cost is higher than going through your insurance company (if approved) but it is still not terribly expensive.

I am 71 and I have been on biote pellets . My endo did not like the idea but I feel that along with the Evenity that is why I had such a great increase in my BMD . I will continue with the pellets . I just had my 1 st injection of Prolia after being on Evenity for a year .