HRT for bone loss

[Wheretheskyisblue]

I started taking HRT 3 months ago in my early 40s due to peri menopausal symptoms. It has been great in sorting out the body aches and hot flushes. Prior to starting HRT I halso had a dexa scan which was - 2.2 so border line osteoporosis (cut off is - 2.4).

I am wondering whether the oestrogen dose is important in protecting bones. I am currently using evorel 50 patches which are dealing with all the immediate symptoms but is it sufficient in dealing with bone loss? I asked my gp but they didn't have any idea.

I am also taking a calcium/vit d supplement and starting more weight bearing exercise but is there anything else I should be taking?

[JinglingHellsBells]

Bone gain is linked to dose. I can't link just now but if you look at the website www.menopausematters.co.uk there is a side bar menu and under HRT you will find all the types - HRT estrogens/ progestins, peri and post meno. Eventually you should find the list of them all. Those with an asterisk are licensed for osteoporosis /osteopenia.

(Your GP ought to be able to find out! saying they do not know is unacceptable. They could ask a menopause specialist or a bone specialist!)

A patch of 50mcg should be enough. I use gel and 2 pumps is around 1.5 mgs which is roughly the same as a 50mcg patch.

One thing- there is increasing research showing that taking calcium as a supplement is bad for the heart. It clogs up the arteries. This has been around for some years but the NHS is very slow to change their advice. If you eat dairy and other sources of calcium you should easily get the 800mg a day you need.

(I was in the same situation as you although older and my bones are now pretty much normal for my age. HRT has helped a lot but you need to keep up the exercise as well.)

[Wheretheskyisblue]

Great thanks for the advice. I found it on the menopausematters site and the 50mg patch seems to be licenced for osteoporosis but it the lowest dose registered.

I am tempted to ask my GP if I can try a higher dose just to make sure, I assume the GP can look up which one is licenced too but I can't find anything which suggests higher is better or not.

To complicate matters I am still breastfeeding but had to tell my GP I wasn't to get the hrt. I had advice from the breastfeeding network this was OK. I assume this means though that my calcium requirements are even higher.

[JinglingHellsBells]

There is evidence online - research papers- that shows estrogen and bone density are linked by dose. As you are young, it would make sense for you be try a 75mcg patch is possible. At the other end of the scale, for older women, ultra low dose estrogen (0.3gms) has also been shown to be bone-preserving so even a small amount does help.

You can try calling the helpline of the Royal Osteoporosis Society for advice and their website also has very helpful lists of calcium-rich food, so you won't need to use supplements - Vit D yes, but not calcium. It's not that hard to get the daily amount by eating a range of dairy or pulses (chickpeas), soya, foods like tinned sardines and salmon, almonds, dried apricots, kale, and other green leafy veg.

[Oblomov22]

Jingling helpful as always. I've just been prescribed Calcium for osteopenia. Hmmmm ....