HRT preventatively (osteopenia)

[whitedahlias]

Any suggestions on a gynaecologist or specialist to talk to about when to start taking HRT preventatively?

I have osteopoenia (ballet and eating disorder in my youth, thyroid issues and steroids for asthma to blame) and while my peri symptoms aren’t that bad yet (I’m 45), it’s my bones I’m worried about.

GP not interested.

London or Home Counties ideally.

Thank you

Have a look at the British Menopause Society website where they have a list of specialists. You can view the list by postcode.

If you have osteopenia, have you been referred to a rheumatologist for ongoing DEXA scans? These should be every 3 years.

Do you know your T-score for your bone density?

My advice is that you focus on the peri symptoms for HRT and the benefit to your bones is a bonus.

The British Menopause Society does suggest HRT for prevention of osteo for women under 65, rather than other drugs.

@JinglingHellsBells thank you.

Yes, I've searched the menopause society and came up with scores of gynaecology cons and specialist GPs.

I've no real idea how to choose between them though and as the fees seem to be around £250 just for an initial consult, I'd love a personal recommendation.

I was thinking I'd avoid those who also seem to specialise in obstetrics or fertility (exciting as those things are, they're all behind me!) and try to find somebody with an osteo focus.

This Dr came up:

Prof John Stevenson

www.johnstevenson.org.uk

He's an endocrinologist rather than a gynae. but is a member, and lists as an interest the impact of menopause on bone health.

Winder if anybody has seen him?

T score was averaged at -2.1. There was no mention of repeating it and my GP says it's not "bad enough" to do anything, exercise, calcium etc.

well, -2.1 is not good as full osteoporosis starts at -2.5

I have heard of John Stevenson and he's well thought of though I don't know him at all or his 'bedside' manner. I'm sure I've read some of his science papers or seen him listed as a contributor.

If you wanted to go straight to a consultant rheumatologist, the best is Prof David Reid who is now the lead dr for the Royal Osteoporosis Society and he has a practice in London. PM me if you want to know stuff I dont want to put in public.

I wanted preventative HRT for a condition that I have after reading research papers that showed it is protective, the nurse told me that she couldn't prescribe it for that purpose but if I told her I had current symptoms she could prescribe it.... Not ideal - HRT could actually save my life - but I did have some other symptoms so I was able to get it for those instead.

@Livelifeinthebuslane really glad you got what you needed. Good tip too, about needing to be within the prescribing rules. @JinglingHellsBells thank you, I will PM you if you dint mind (once I work out how) x

'T score was averaged at -2.1. There was no mention of repeating it and my GP says it's not "bad enough" to do anything, exercise, calcium etc.'

Go back to your gp and ask for/demand nhs referral to a specialist (unless you are comfortably in a position for private treatment). That T score is bad enough at 45 and they should be taking a really proactive approach here. Good luck.

I can't comment on the HRT directly (except to say that I plan to take it myself) but I also have osteopenia and am a similar age. Have you ever had your vitamin D levels checked? Mine were pretty low and I started taking a high dose which got my level up to the high end of normal range. My osteopenia improved significantly within 9 months, which my endocrinologist believes is likely due to the vitamin D. I can't remember my initial T score, but I believe it was borderline osteoporosis. At the scan following vit D supplements it was - 1.3. In some areas the bone density had improved by almost 10%. Might be worth looking into?

@Reallybadidea thank you, I had them checked about 13 months ago and was told they were "normal". I have done a bit of research though and it seems that "normal" isn't actually necessarily enough.

Well done on your improvement, that is great!