Sleepless nights I get. I may have gotten 5 hrs sleep last night. My sleep has improved over the last 3 months, last night was just a bad night and I have a lot going on that I’m sure isn’t helping.

Have you thought about having genetic testing prior to starting HRT? I have Ashkenazi DNA and I wondered whether or not I should get tested if I want to try HRT. Neither of my grandmothers had breast cancer, and I feel 100% confident that there’s no history of it on my mom’s side of the family. Neither my father’s mother nor sister had it either but I don’t know much about my paternal grandfather’s family.

A few yrs ago, we had to evacuate for a hurricane. We were only taking one car and I was trying to decide where the best place was to leave the other car (lived in a high risk flood zone at the time). As I debated where to leave the car, I finally blurted out, “There are too many variables,” and that’s exactly how I feel about dealing with my bone density issue. If I do HRT and end up with cancer because of it, then I’ll need cancer meds which could make my bones worse and mean that I’ll have no choice but to take even higher doses of zoledronic acid, and osteo-meds are what I’m trying to avoid.

I know it’s easy for me to say, because I’m not you, but I really think you should do HRT. Ask your cousin, or her mother, if the other side of your cousin’s family (meaning the side you aren’t blood related to) has a history of breast cancer—it might not be in your genetic makeup.

My 1st DEXA in July 2019, age 50, showed my lumbar spine t-score was -3.9. My most resent DEXA in December 2022, showed my lumbar spine t-score was -3.6.

I took alendronate for 1.5 yrs and had 1 zoledronic acid infusion in November 2021. My doctor expected me to have another infusion in November 2022, but I opted not to.

In addition to the osteoporosis, I have hypothyroidism and I’m not sure that bisphosphonates are the answer for some with BTM (bone turnover markers) in the normal range—I don’t have elevated BTMs.