Connect
Effects of HRT: Alone, in Combination or Sequencing
Have you used HRT as the sole modality for osteopenia or osteoporosis? How about using it in a therapy sequence or in combination with another osteodrug, either an anabolic or an antiresorptive? What is the outcome of such choice(s)?
After a diagnosis of osteoporosis nearly 3 years ago, I elected Forteo as my first drug therapy then transitioned to HRT afterwards. Forteo gave me a jump start on building bones: lumbar bmd +8.6%, hips r/l +4.8/2.2%, femur necks r/l +8.9/3.4%. Bmd improvements are as follows after 22mo Forteo followed by 6mo HRT (scans were done with same machine and by same tech):
Lumbar spine bmd +18%, T score from -3.4 to -2.3;
Right hip bmd +9%, T score from -2.3 to -1.8;
Left hip bmd +4.1%, T score from -2.1 to -1.8;
Right femur neck bmd +16%, T score from -2.4 to -1.6;
Left femur neck bmd +9.8%, T score from -2.5 to -2.0;
TBS from 1.264 to 1.322
So far so good but I know this is just the start of a long road ahead.
I’m very grateful for the existence of Mayo Clinic Connect. Without this forum I’d never thought HRT would be in the cards as I’m more than 10 years past menopause. Many thanks to @vkmov for initiating the thread “Transdermal HRT”, @teb for her generous sharing of personal experiences, and countless members for their in depth discussions and suggestions.
The inclusion of HRT in the management of osteoporosis isn’t mainstream, in fact it is not approved for the treatment of osteoporosis so data and evidence are lacking. It will be helpful if we could share the outcomes of HRT among those of us who have chosen to use HRT under the care of our team of physicians. Dexa results possibly with bone turnover markers and/or TBS info if available will be nice. By the way, my CTX trended down to 163 after 6mo HRT from a high of 793 at end of Forteo treatment, a change I didn’t anticipate at all.
Any comments or analysis are welcome; and best luck to us all no matter what therapy path(s) we choose!
Like
Helpful
HugInterested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.
Connect
Hi, thank u for getting back to me.
They are saying that BHRT is not successful and is not used to treat osteoporosis. They also say that at my age of 66, the risks outweigh the benefits.
I have read that BHRT is used in treating osteoporosis and I am soo confused. I think the BHRT would bless risky than Fosamax. I have read some awful things about Fosamax and I am afraid to take it.
Can I ask if the BHRT has helped with your osteoporosis.
Thank u again for reaching out to me. I appreciate it. ❤️
Thank u!
-
Like -
Helpful -
Hug
1 Reaction@gravity3
Awesome you found a functional med dr who is helping you! I have looked and they are few and far between where I live. Unfortunately, the 2 I have looked into are prohibitively expensive for me and of course not covered by insurance. I'm hoping to find the right endo or gyno dr who will be willing to explore HRT for me.
Keep reaping those benefits!!
No, it did not. I went from -1.3 to -2 in my spine for the four years I did HRT plus calcium, vitamin D plus exercise.
I started on Fosamax and my spine improved to -1.5 in the first two years. It remained stable for another three years until my fracture (-1.6 just before I fractured). Last score in June was -2.2.
Of course, it may have been a lot worse without the HRT so I hoped it helped.
Could you list the type of HRT; Estradiol, Estriol, testosterone, progesterone.....
Dosage and delivery system
Thanks for your reply! I'm sorry to hear about your fracture. It is puzzling to fracture at a T score like that, isn't it? Hope it has minimal consequence and that your current anabolic treatment helps to build quality bones.
Hi @kisu I am using estradiol (generic for Vivelle Dot) 0.025mg/day transdermal patches and micronized progesterone (generic for Prometrium) 100mg gelcap to be taken orally before bedtime. No testosterone - since the cardiologist whom I sought for 2nd opinion advised me not to use testosterone due to my existing mild CAD (I have a cac score of 38).
-
Like -
Helpful -
Hug
2 ReactionsI am only 4 months into using bhrt. I am in the same boat trying to figure my own bone journey. Some of the others will have more to share than I.
Thank you. I wonder if the suppression of bone remodeling played a role in my fracture. I was heavily active during the period I was on Fosamax, lifting heavy weights and increasing exercise in the belief that stressing my bones would lead to building more bone. I did not know that bone remodeling eventually stops on alendronate.
-
Like -
Helpful -
Hug
1 ReactionI am 76 and I cannot find a dr who will prescribe hrt estrogen and progesterone. instead the thick uterine lining is being probed. I sense through much research that the hrt is enough.