Began Tymlos 4 wks ago; flying solo till I see Endo in 3wks... advice?

@idlehands honestly I am horrified! I try really hard to be accurate and provide sources!!

windyshores I'd venture to say that most readers on this forum have learned as much from your posts as from anyone. You're entitled to zone out every now and then. No harm was done. Don't beat yourself up.

I had twins at 41 in 2004 and when I came up for air 8 years later it seemed to be the peak "don't-even-consider-HRT-for-fear-of-breast-cancer" era.

I next thought about pursuing it when I learned that the cancer concerns had been largely debunked, but then Covid was hitting so I back-burner-ed it again. THEN when I finally tried to pursue it last year (before knowing I had OP), I was met with the notion that 61 was too old to start (!).

I am super interested in it and I'm going to broach it with the endocrinologist I'm seeing in a couple of weeks (although I suspect I'll have to keep shopping further for a provider willing to consider it for someone my age).

@windyshores, I completely agree with @idlehands about learning from your posts.

Hi @annie208 you might have read the thread "HRT safety" on this forum. If not, here is the link:
https://connect.mayoclinic.org/discussion/hrt-safety/
The thinking is changing with HRT use for those of us who are more than 10 years past menopause. Basically the risk vs reward is assessed at individual level. If a sizable medical center or an university hospital setting is nearby, the doctors there are more likely practicing with updated information. I'm a tad younger than you and it took me about 6mo to get fully evaluated - mainly cvd risks and breast cancer risk. I didn't encounter noticable reluctance.

I think your situation especially the fracture calls for a good discussion with your endo to figure out whether or not it's "fragility fracture". This will have an impact on you Frax score hence the "aggressiveness" of treatment for the next ~30 years. Personally I felt long term maintainence after the initial anabolic therapy is a lot more daunting in the absence of sufficient information and tools.

@mayblin THIS!
"Personally I felt long term maintenance after the initial anabolic therapy is a lot more daunting in the absence of sufficient information and tools."

So well put.

That l
ink was interesting @mayblin. I had breast cancer driven by estrogen; 80% of breast cancers are hormonal and 1 in 8 women get breast cancer. Most are older. I was interested in this:

Elevated Breast Cancer Risk Can Be Mitigated
With a therapy combining estrogen and progestogen, both estrogen plus progestin and estrogen plus progesterone were associated with a 10%-19% increased risk of breast cancer, but the authors say that risk can be mitigated using low doses of transdermal or vaginal estrogen plus progestin.

"In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with E2 (estradiol) rather than conjugated estrogen," the authors writemayblin I was interested in this:

"In the WHI, 70% of the women were over the age of 65 when they initiated therapy, which partially accounts for the negative outcomes. In addition, in WHI, everyone was taking oral [HT].

and this:

Elevated Breast Cancer Risk Can Be Mitigated
With a therapy combining estrogen and progestogen, both estrogen plus progestin and estrogen plus progesterone were associated with a 10%-19% increased risk of breast cancer, but the authors say that risk can be mitigated using low doses of transdermal or vaginal estrogen plus progestin.

"In general, risk reductions appear to be greater with low rather than medium or high doses, vaginal or transdermal rather than oral preparations, and with E2 (estradiol) rather than conjugated estrogen," the authors write.

But I still cannot go near hormones with a previous cancer!! This should be reassuring for others.

@windyshores , I still THANK you because your reply was still helpful!

With my total hip T score of -2.6, even using 5% (instead of .5) as the margin of error, your statement about my possibly not being fully over the "line" to osteoporosis still applies (95% of 2.6 being 2.47). Be well and many thanks for all the help on here!

Thank you for these kind and validating words.

I always say that on a good day I'm a self-directed, proactive patient who advocates for herself. (But on a bad day I admit I'm probably many providers' nightmare of a google-happy, chronically-researching patient!)

I went through a number of years of being uninsured before the Affordable Care Act and I would get labs from health fairs and just buy appointments from quick-care providers as needed. (So my old "self-management" habits die hard!)

This haunts me, too. When I finally meet with him, I am open-minded to my new endo possibly telling me to suspend Tymlos/anabolics and just focus on diet, exercise, and supplements for now. I just hope he's willing to really drill down and try to determine if my fracture was a "fragility" fx or not...

My frax score didn't get the bump it would have if my mother had broken a hip, but she HAS broken 2 bones in her feet in her early 80's just standing and twisting the wrong way and my maternal grandmother broke her hip at 81 from standing. (So I do wonder how accurate my frax score really is.) (Mom has dementia now, but her recent total hip T-score was -3.6. She had two years of Reclast infusions 10-12 years ago and I need to take her in to see about further treatment given her recent Dexa results.)