Help finding HRT over 10 years post menopause

Dr. Jen Gunter (an OB-GYN) on Substack is a menopause specialist worth following. She reviews new studies, documentaries, and FDA panel discussions, and does a good job separating evidence from marketing. I appreciate that she pushes back on claims that go beyond what clinical trials have actually shown.

@mayblin

Lots of great info to read and ponder. Left with a feeling of overwhelm.

Another good podcast from Dr. Stricher: Your Bones on and Iff Estrogen:
https://open.substack.com/pub/drstreicher/p/your-bones-on-and-off-estrogen

While not everyone may be able to take systemic hormone therapy, vaginal estrogen is safe for everyone. And while vaginal estrogen won’t help bone density, it can prevent hip fractures and urosepsis. Dr. Stricher has pointed out that women often break their hip running to the bathroom due to incontinence, which can be prevented with vaginal estrogen. Here is a podcast with urologist Dr. Rachel Rubin:
https://podcasts.apple.com/us/podcast/dr-streichers-inside-information-menopause-midlife/id1615785832

And another good post from Dr. Stricher; 15 Reasons Women are Denied Estrogen and 15 Reasons Why Estrogen May Still Be an Option:
https://open.substack.com/pub/drstreicher/p/15-reasons-women-are-denied-estrogen

*2026 May. I am newly diagnosed with spine osteoporosis, a diagnosis a result from pain radiating to “under my (front) ribs on left side. An X-ray performed finding “age related compression fracture” in my spine from a fall several months prior.
Jumping back…,
*2017 DXA results: “L1-2 excluded for significantly different results when compared to adjacent vertebrae”.
AP Spine (L3-4) -0.91.1 normal. This is 2017.

*2026 DXA (after that Xray) gave results;
femoral neck 0.655,
total hip left 0. 835,
total fore arm right, 0.450,
1/3 forearm right, 0.533,
UD forearm right 0.352.
There was no scan of my Spine saying that they were not able to do that area!!!

I don’t understand this?
If I go onto the recommend RX anabolic 2yr treatment for the diagnosis of osteoporosis of the spine (due to my compression fracture), how will they monitor my spine’s improvement, if they cannot take a DXA of that area, prior?

I read here about the details of improvements to the bone in the spine of those on Rx therapy. Is that totally from undamaged spines, with no compressions or herniations?
Does everyone else get Bone Density tests of their Spine?
I’d like to hear your input and experiences, because I feel I need to push back on this, before I commit to Rx therapy.
Thank you very much.

@countryliving
What were your t-scores?
I know that DEXA can give inaccurate results if there is arthritis in the spine; can actually make the results look better. I have not had one yet, but the REMS scan are able to give a more accurate picture with arthritis. I also know that if you can get a DEXA that offers TBS (Trabecular Bone Strength) software, that can give a better picture of overall risk. There are others who know more about this and can give you more detailed information. You may want to check out the REMS or DEXA topics.

Age 68 female. Post menopause at least 10 years. Experiencing extreme fatigue therefore I have gone back on hormones - Bioidentical (BHRT). You can do this long distance. Call Dr. Caputo. Crestview Florida. He'll have you do blood work. Zoom meeting. Order your prescription and pharmacy can mail out to your home. Easy.

I was put on a Transdermal Patch when I had my hysterectomy in 1990. I'm still on it. I've had Osteopenia for years, but this year it progressed to Osteosporosis in my hips. But, I went to a bone specialist and now doing leg & hip exercises daily, as well as using a Senior Tred Mill from Amazon, which I love. I also started taking calcium. I hope that my next year's visit will show improvement.

@cliffdweller
Thank you for getting back to me.
I thought I listed my scores in my monologue written/posted? But I can’t find my post here now! Geez! Maybe the administrator took it down? I’m obviously new here. I was hoping for more input from others, and I really appreciate your suggestions. I will research what you said and discuss with my endocrinologist. I haven’t heard back from her yet, regarding my labs performed last week, Thursday.
The 24 hr urine test and 11 other blood tests all came back totally within normal range, except creatinine lab, which was a few points below the lowest (normal) range suggested. (I am able to log into my medical chart, to view results, although they have not been signed off on yet by the (ordering) MD.). So with all positive results - I don’t know what’s going on. It scares me the thought on going onto the anabolic Rx, since I’ve read the side effects, and also read the struggles many people have had.
Thank you again. I wish you well on your health journey.