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Femoral neck -2.8: Would you start treatment now?
From Osteopenia to Osteoporosis in Five Years - what would you do?
Hi everyone, I'm 57 and was recently diagnosed with osteoporosis after progressing from osteopenia over the last five years.
My 2026 DXA results are:
Left femoral neck: T-score -2.8 (osteoporosis)
Right femoral neck: T-score -2.3
Total hips: -1.7 and -1.9
Lumbar spine average: -1.2 (although I'm investigating whether this may be masking more significant bone loss, as L4 alone is -2.2)
My previous scan in 2021 showed a lowest T-score of approximately -1.3, so the drop to -2.8 has been a shock. I went through menopause without HRT, had a demanding job, did very little exercise, and paid little attention to bone health. Although my doctor knew I was menopausal and had osteopenia, I wasn't aware how much bone loss could occur during this period. I have seen my doctor and am being referred to a specialist. MHT/HRT and osteoporosis medications have both been suggested. I am now about five years post-menopause. I don't have menopausal symptoms such as hot flushes, and my main concern is bone health.
My dilemma is deciding whether to:
Start MHT/HRT now and see whether it helps protect bone.
Go directly to osteoporosis medication.
Spend 12 months focusing on exercise, nutrition, calcium, vitamin D, and strength training, then repeat the DXA before making a treatment decision.
I am also concerned about the long-term commitment involved. MHT may be reasonable for five years, but I'm uncertain about the balance of benefits and risks beyond that, and I've read about the potential for bone loss after stopping treatment.
My questions are:
Has anyone started MHT/HRT around five years after menopause primarily for osteoporosis?
Was it worthwhile for your bone density?
Did anyone choose to monitor and focus on lifestyle changes for a year before starting medication?
If you had a T-score similar to mine (-2.8 at the femoral neck), what treatment path did you choose and why?
Looking back, would you make the same decision again?
Thank you. I'm still coming to terms with the diagnosis and would really appreciate hearing about other people's experiences.
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@agag my Dexa before 2024 were steady -1.7 was lowest score. 2024 is when I had a drop. I think most of it was caused by loosing 50lbs. I did not eat enough protein and calcium for my bones. I was hoping my 2026 Dexa would be the same and not worse. I can't tell you how much HRT had on my increase, but I know it didn't hurt.
The impact was a gradual build up. I started with heal drops, stomps. Now I do fast step up with weights, fast skipping, and step jump down with rebound. I don't do this one all the time. I hope it helps
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2 ReactionsTake the meds for bone repair
@hdeff
I included testosterone with my bhrt. We have both estrogen and testosterone receptors. Great for libido!
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1 ReactionDear everyone if you have not started meds fr bne health PLEASE read "your bones" by Lora PIZZORNO/ It is a MUST read before you take meds
@gravity3 I've been considering testosterone too, because I hear it's good for your bones (and muscles).
@dvargo Can you please give your age? It's important to many of us older women. I am 76 and want to discuss HRT with my doctor. Thank you.
Bone loss in my cervical spine increased over a five year period in spite of my weight bearing exercise routine, prescription vitamin D and sufficient calcium intake. I was on HRT prior to my progressively worsening bone loss. You may benefit from asking your doctor for a complete assessment of the benefit/risk ratio. HRT has risks and is not always the best option.
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1 ReactionI know each person has to do what is best for them, and each situation is very personal, but for me, I would do everything I could to avoid osteoporosis meds. I definitely would start with HRT ( I was on it in the past), which has been badly maligned, by only one poor study done 30 years ago, which took hold in the medical profession, and all women were either taken off HRT or discouraged and scared to use it. HRT would be very helpful in stemming the bone loss, as well as being beneficial for heart health. Supplementing with high quality products aimed at osteoporosis, and working out with weights, or weight bearing exercises, as well as diet would be the way to go. Give yourself a year, and repeat your DEXA scan.
I am -3.2 in hips, not on any meds, work out, take Bone Maximizer, an easily obtained supplement, add natural calcium to your diet. There are lots of interventions, which may help. Do some balance work. The best way to avoid a fracture, is to avoid a fall.
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2 Reactions@daisy17 I started HRT at 64, now 67. I increased my bone in one year by 5%. Traditional doctors do not have training to help. See a functional doctor.
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1 Reaction@dvargo I am 76 so need to discuss this with my doctor. Thank you.