Struggling with making an osteoporosis treatment decision

@jimmy05, I am still taking 70 mg of alendronate once a week. Next year I will have to stop after taking it for 5 years. I have had one Dexa scan. My spine improved to osteopenia, but my hips didn't. I'm probably due for a dexa scan this year.
I hope things go well for you!

I have had unprecedented treatment for bone loss with estrogen and progesterone for seven years. I will share some of my pros and cons, and risks of this controversial treatment.
Cons:
1. Discrimination- Some Providers think I'm taking the drugs for sexual functioning. Some of them have been down right rude, even vindictive. This was not my goal. I like walking, running, and I have to keep working indefinitely. I have been sexually abstinent for many years like most unmarried women in my age bracket. However, I think the number #1 reason for some of the negative attitudes that I receive is that it has without a doubt, slowed the appearance of aging. I still get carded for alcohol purchases and I am almost 70 years old.

2. Toxicity- Most people don't know that pure estrogen and progesterone are toxic. You can never wind down after using these drugs. It's akin to insulin or other drugs that your body has become dependent on having to function. Your body becomes addicted and isn't nice if you try to reduce or step down the usage.

3. Costs- The cost of estrogen is pretty expensive. There are no generics for a reason. The drug is toxic, but plays a vital role in the human body. It effects the body in a number of ways which I will outline in the "pros" section.

4. Finding doctors to prescribe the drug are not easy. Most are uncomfortable and don't want to be blamed or associated for its alleged cancer risk.

5. Finally, it does increase sexual desire and this is a disadvantage if you are older woman and not married with a sexually functioning spouse. Males in your age backet after age 60 are not going to be comfortable with a woman who has strong sexual urges.

6. Finally, our bodies are akin to old cars as we age. You can fix something and it might work, but it affects something else and the old car still isn't working properly. An example would be, suppose you replace the altenator in your car, but your fuel injection system is sluggish. You still have an issue with the car. In my case, the preservation of bone matrix was my motive for hormones, not preservation of sexual function. However, my bone marrow and liver are having trouble keeping up with bone remodeling from the estrogen.

Pros:
1. Without question estrogen is a miracle worker for bone matrix and bone remodeling activity. However, be warned that bone marrow is also aging and may not be able to keep up its production of RBCs with constant bone remodeling in older women.

2. Estrogen has increased my overall brain functioning (not including memory), but with other areas of the brain.

3. Estrogen also improves my heart function. Most people don't realize that estrogen is key component in heart functioning in women. However, it does not stop functioning after menopause with losing estrogen, but doesn't function as effectively.

3. My reproduction status is unclear. No one wants to address this issue with someone in my age bracket.

4. Exercise and circulation have improved, but I must excercise frequently and vigorously to accommodate the bone remoldeling activity.

5. Hair, skin, and nails are far more healthy than my peers probably. My hair grows fast and it is full. However, I still fight old age facial hair and have had most of it removed.

6. I walk extremely well, my skeletal frame is intact, but I do have joint pain which I believe its lack luster performance is because of declining bone marrow activity. But it could be genetic, parasitic, or anemia not related to the estrogen.

I hope my experience will help others, both patients and practitioners develop a good assessment for using hormone therapy. Women should be able to make their own decisions about their bodies. I stand by my decision and I am happy with the choices I've made.

@sunnyflower
Wow. Just happened onto your post, my first time in this group. Now I get it!

It's October 8, 2025. I've just gotten off the phone with Evenity. The woman was rather stiff answering my questions.
How long on the market? Since 2019. Where can I read the study mentioned in your literature; when was the study; who conducted the study; any other information? She said she had to refer me back to my prescriber. For. every. question.

Very disappointing. Very frustrating.

@consumer
I never heard of Evenity, but I did Google it. It is a protein based chemical compound with severe heart warnings. Also, protein plaque affects our brain function as we age. Estrogen helps brain function. The Evenity compound is not natural to the human body. Pure estrogen or other medications with estrogen are natural to the human body. Our bodies stop making it after menopause. However, estrogen is key in heart function when we are younger, probably due to the preparation for pregnancy. Our hearts can still function without it after menopause, but not as well. Also, I was warned that the use of estrogen for more than two years increases substantially cancer risks. I haven't seen the studies that support this information.

I will say that like any drug, every woman who uses estrogen should check for genetic predisposition for breast, ovarian, or uterine cancers. It is a gene test. Premarin has incredible potential for slowing the aging process for women.

However, our bodies' cells have something called "programmed cell death." Every cell knows when they are ready to die and let it be known by something called pain and/or discomfort. Estrogen has a way of delaying or masking that genetic trait in women, and cell death is present in all living things. But our other billions of cells are not all on board with masking or delaying cell death. So you have a conflict going on in your body, if you choose to try estrogen; the conflict may not be pleasant either.

Finally Estrogen brand name is Premarin and there is no patent for a generic. It's made by Pfizer a well respected drug manufacturer. I don't think there are enough women using Premarin to accurately predict outcomes of long-term risks.

Keep in mind that my nursing studies are slow and on going when evaluating my opinion. I am a 69 year-old older woman. While I have completed all the nursing prerequisites, I still haven't passed Nursing Physiology yet for nursing school. But I have passed five technical certifications boards and the NBCC counseling board as a graduate student, earned an associate degree in Nursing Education, and passed pathology/PBT board exam, and earned an ASCP certification.

Thanks for reading!

@consumer
I never heard of Evenity, but I did Google it. It is a protein based chemical compound with severe heart warnings. Also, protein plaque affects our brain function as we age. Estrogen helps brain function. The Evenity compound is not natural to the human body. Pure estrogen or other medications with estrogen are natural to the human body. Our bodies stop making it after menopause. However, estrogen is key in heart function when we are younger, probably due to the preparation for pregnancy. Our hearts can still function without it after menopause, but not as well. Also, I was warned that the use of estrogen for more than two years increases substantially cancer risks. I haven't seen the studies that support this information.

I will say that like any drug, every woman who uses estrogen should check for genetic predisposition for breast, ovarian, or uterine cancers. It is a gene test. Premarin has incredible potential for slowing the aging process for women.

However, our bodies' cells have something called "programmed cell death." Every cell knows when they are ready to die and let it be known by something called pain and/or discomfort. Estrogen has a way of delaying or masking that genetic trait in women, and cell death is present in all living things. But our other billions of cells are not all on board with masking or delaying cell death. So you have a conflict going on in your body, if you choose to try estrogen; the conflict may not be pleasant either.

Finally Estrogen brand name is Premarin and there is no patent for a generic. It's made by Pfizer a well respected drug manufacturer. I don't think there are enough women using Premarin to accurately predict outcomes of long-term risks.

Keep in mind that my nursing studies are slow and on going when evaluating my opinion. I am a 69 year-old older woman. While I have completed all the nursing prerequisites, I still haven't passed Nursing Physiology yet for nursing school. But I have passed five technical certifications boards and the NBCC counseling board as a graduate student, earned an associate degree in Nursing Education, and passed pathology/PBT board exam, and earned an ASCP certification.

Thanks for reading!