← Return to Mild osteoporosis DEXA scores: what would you do?

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@teb

It would be an option for you to explore. There are risks in taking any medication whether they are osteoporosis meds or hormones so you have to decide which risk you are most comfortable with. There's also the "do nothing" or "diet and exercise" approach which risks further bone loss and fracture. These are really tough decisions for each of us to make. Personally, I chose pharmaceuticals that I felt were most "natural" to the body after a failed diet and exercise approach led me to go from -2.8 in my spine to -3.2. I knew I needed a bone builder at that point and since Forteo was synthetic parathyroid hormone, and mostly built spine where I had all of my loss (typical of bone loss progression, from spine first to hip secondarily), I felt that it was something the body was accustomed to and recognized. The same with hormones. I am replacing something that was natural to my body and that maintains bone in a natural way so I chose that after Forteo to maintain the gains. Hormones were once readily prescribed for osteoporosis but that changed after the results of the WHI study were widely publicized and vastly misrepresented. You can still get a prescription for HRT from your gynecologist for "menopause symptoms". If they are reluctant, you can use an online service such as Alloy Health if you are in the USA. They have MDs on staff who are menopause specialists and will evaluate your situation and prescribe a dose they feel is appropriate. You do this all by email. There are no fees unless you chose to proceed with a prescription and then you are charged for the medication only. If you want a more in-depth consultation with a physician, that is available for a $35 fee and is done through private messaging on their website. The lowest dose of transdermal estradiol is .025 which is also considered the safest and is a dose that is likely sufficient to stem bone loss. I was on that dose for 5 years. I've had only the slightest loss in all that time so I just increased my dose to .0375 as a further safeguard. If you have a uterus, you must be on progesterone as well and the safest option is bioidentical progesterone, not synthetic progestin. The typical dose prescribed is 100 mg oral.

Here are some options for you to read further:
Estrogen Matters by Dr Avrum Bluming
https://evidence.nihr.ac.uk/alert/risk-of-breast-cancer-with-hrt-depends-therapy-type-and-duration/

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Replies to "It would be an option for you to explore. There are risks in taking any medication..."

I think the original poster subsequently posted that the endocrinologist advised her that HRT was not an option. Perhaps as a first step, the basis of that medical opinion should be fully understood.

Thank you so much @teb. This is all relevant to my situation, as is your noting that hip scores tend to fall after spine. I will use your information while proceeding.