Study suggests hormone therapy may help protect bone health in women
Can hormone therapy protect bone health? https://www.medicalnewstoday.com/articles/hormone-therapy-may-increase-bone-density-prevent-osteoporosis
By Annie Lennon on May 13, 2023 — Fact checked by Jill Seladi-Schulman, Ph.D.
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@ctpaul, thanks for posting the link to the article about hormone therapy and bone health. Please note that I removed the copied text to avoid copyright enfringement.
I found the article interesting, especially the part stopping HRT and its effects on bone health. What stood out for you of key importance in the article?
All of the women whom I know who are taking HRT are doing so in the expectation that the benefits include some protection against, or delay of, osteoporosis. The glitch is whether doing so increases the odds of developing breast cancer and there are vocal proponents and critics on both sides of that discussion. I'm hoping that the science will evolve to show some clear pathway of threading the needle to reap the benefits and dodge any extra risk.
From what I've read in several places, the fastest-growing rate of new, first-time breast cancers is among older women and epidemiological statistics are suggesting that years of HRT will be shown to be a contributing factor. As someone who had a lumectomy 18 months ago, I sometimes ponder the plethora of Hobson's choices available to us when trying to make health decisions.
Thank you for sharing this important information. I opted to go on HRT after I completed 2 years of Forteo . After much reading and careful consideration, I felt it was the best and most natural option for me and my bones. I was about 10 years out of menopause which was not optimal but none of our options really are. It's been about 3 years and I've mostly maintained my density.
The issues of concern with HRT were raised in the Women's Health Initiative Study which turned out to be a somewhat flawed study and the negative results were exaggerated and overblown by the media causing a steep decline in usage. More recently, it is coming full circle and more and more, HRT is being considered a viable option for women to preserve their bones and ease menopausal symptoms. If you have had breast cancer or CVD or have a genetic risk, I can understand not wanting to utilize this option but if those predispositions are not present, I think it's a viable option. I'm really glad I'm on it (along with progesterone which is necessary since I have a uterus). I only wish I had gone on it earlier as my naturopath had suggested about 10 years ago. I was too afraid and wanted to get through menopause naturally. Had I listened to her, I would likely still have a healthy spine and better quality of life.
I'd love to know if others are on HRT and at what dose. I currently use the lowest dose of .025 estradiol transdermal patch and 100 mg progesterone (which seems to be the agreed upon dosage of progesterone to counter risks). I'm considering increasing my estradiol with the hopes of greater preservation. Anyone on HRT? What dose and method are you using?
If I can find this I'll post a link to it but I came upon an article recently wherein two oncologists debated HRT for women who've had breast cancer. One doctor was adamantly opposed to HRT and another pointed out that the Woman's Health Initiative Study had a lot of issues, with much of its methodology since disavowed, and he thinks that HRT is not a risk for women who had breast cancer at all. As we know it's always confusing when the experts disagree but I wonder if, somewhere down the line, estrogen will be considered safe for a woman to take even having had breast cancer some years earlier. If so then one can hopefully try to protect against bone loss from the years of not having estrogen.
I think this is similar to the Lupron debate for men with prostate cancer and the question of how long and how much Lupron is safe and when can someone discontinue it safely and even take drugs to resupply the body with testosterone. That is, research is looking at how long a body needs to be deprived of a hormone that, at one point in time, fed a tumor without assuming it always will trigger the same outcome.
More research needs to be done. The flawed one for nurses needs to be discussed and redressed, esp for bone health. I had a hysterectomy at 40 and used only the estrogen patch @ .025 for over twenty years. I discontinued years ago S I had knee replacement surgery and doc. was concerned about clotting issues. I now have severe osteoporosis. Would it help to go back on the patch?
That's an interesting question. Since you don't have a uterus and therefore there is less risk being on estrogen only (and even less so on transdermal), it would seem this is something you could explore with a knowledgeable and progressive physician (I know…hard to find!). The more I read, the more I think I'm going to be on it forever. Perhaps there is some additional risk to that but we have to take our risks somewhere. I'd rather take my risk with something that restores the hormones in my body rather than something that creates new pathways to bone maintenance. Not that I'm opposed to that either if needed but I'd like to use those options minimally.
I've heard interviews with Dr Felice Gersh who is an integrative ob-gyn located in Irvine, CA. She is very knowledgeable about and very pro-HRT. I plan on seeing her to figure out whether my dosing is adequate and to determine a long-term plan. I'll report back on that (but could be awhile). Another doc who is well-versed on using HRT is Risa Kagen though unfortunately, she no longer sees patients. I believe she does consulting and research at this point. As a start, it might be worth looking up those two docs to read about their positions.
I had been on bioidentical HRT around the time of menopause but discontinued it after about a year and a half due to the expense. I wish my Functional Medicine OB-GYN had stressed to me how important it was to stave off bone density loss! A dozen years later, I have osteoporosis of the spine and osteopenia elsewhere. She put me back on bHRT, but at a minimal dose (50 mg progesterone cream, 0.025 mg estradiol patch). I seemed to have had an allergic reaction to the 100 mg progesterone capsule as well as premenstrual type discomfort.
Now I am hyper- focused on trying to make up for lost bone via exercise, diet, supplements and low intensity vibration twice a day. Doing everything I can to avoid the hard OP drugs!!!!
I have been interested in reading about HRT therapy because it makes sense to me. What I would like to know is, would it be alright for someone who is 80 to take it?
I would appreciate hearing what you learn from seeing her. I "think" that the HRT discussion for women who've had breast cancer was in one of the APSCO emails but haven't yet found it. If/when I do, I'll post a link so all can read it.
I declined anastrozole after a lumpectomy after much thought and appreciating all of the ways estrogen works in the body, even smaller amounts after menopause. I was concerned about the effect on bone regeneration and arterial endothelial tissue and cholesterol. The latter two were important as I come from a family, most members of which die of heart disease or strokes.
I have familial high cholesterol but, luckily and inexplicably, excellent coronary calcium and carotid artery test results last month. As an aside to those worried about osteoporosis and taking calcium, I've been taking calcium plus vitamin D3 and vitamin K2 for almost a decade now and my recent calcium score is, according to my cardiologist, excellent. I mentioned this because some people are afraid of taking calcium and I was always told that vitamin K2 is important in protecting against arterial plaque buildup. I don't know if the K2 is the critical factor but a decade of taking calcium is continuing to keep me in the osteopenia zone. Even with some actual improvement in Dexa score, and my arteries don't seem to be evidencing any worrisome build-up. I do make some effort to get a lot of the calcium from diet but also take supplements.
Where did you find 'Vitamin K2' ? I have looked for this but have not been successful.