Risk of osteoporosis?

[CouldBeOuting]

I was put on HRT during the pandemic because that was considered “first fix” by my GP (I have since been diagnosed with two auto immune conditions which cover all the symptoms). GP said I should stay on HRT as there is no increased risk of breast cancer according to new research and it will “protect your bones against osteoporosis “.

I had an HRT review last week - over the phone as face to face STILL not offered (haven’t SEEN anyone at my surgery since way before the pandemic) and the person I spoke to claimed not to know about any of my medications, despite the fact I get my repeat prescriptions from the GP and it is them that handle my extra Covid jabs. She then told me that “there is a very large increased risk of breast cancer” and “you should take a calcium supplement because of the increased risk of osteoporosis “.
What the hell? Who do I believe? I had a mammogram at 50 but not due another until 55. My rheumatologist says NOT to take any supplements as most contain stuff I shouldn’t have. I THOUGHT HRT protected against osteoporosis!

Have any of you lovely meno ladies been told that there is an increased risk of osteoporosis?

Oestrogen as part of HRT is protective. Referenced article here https://www.balance-menopause.com/menopause-library/does-hrt-really-keep-my-bones-strong/#:~:text=There%20is%20clear%20and%20strong,their%20bones%20as%20they%20age.

How annoying for you to be given two completely different opinions and BOTH wrong!

I'm confused by your last line. Did the dr mean HRT increased your risk of it?
If this is so, the GP ought to be spoken to.

Are you at risk from osteo anyway?

There is a very small risk of breast cancer with HRT. But it also depends on the type. Micronised progesterone (Utrogestan) shows no added risk for 5 years' use. It's not clear what the association is with HRT and breast cancer. Many specialists think that estrogen stimulates an existing cancer which would have shown up anyway and that the type of progesterone used is also a factor.

The risk for other types (not Utrogestan) is less than 1 extra case per 1000 women a year.

Calcium supplements do not prevent osteoporosis. There is now a trend to stop using them as they have been linked to hardening of the arteries. Medical advice is your get your 700-1000mcgs of calcium a day from food.

HRT does protect bones but usually it's needed long term (10 years and longer) because if you stop after just a few years you may still live for 30 years without much estrogen.

Menopause is the osteoporosis risk as oestrogen is involved in the process of building bone. Taking oestrogen, weight bearing excercise like walking and getting as much calcium in your diet and a Vit D supplement all help protect your bones.
Im not sure if wires were crossed and the gp meant take calcium as an extra precaution because of menopause being the risk or the HRT? Id email and ask for clarification and a link to this supposed huge risk of BC.

Calcium supplements do not prevent osteoporosis. There is now a trend to stop using them as they have been linked to hardening of the arteries. Medical advice is your get your 700-1000mcgs of calcium a day from food.

I had read this on a blog by a cardiologist. Can you point me to any studies please? I already have osteoporosis and take alendronic acid. My GP insisted I took calcium as well and I feel wary of ignoring their advice. Also 1000mcgs in diet alone is quite tricky.

Thanks for the responses. The HRT review was with a nurse (over the phone). She definitely said that HRT increases the risk of osteoporosis and I should take a calcium supplement. I told her that I eat / drink a lot of dairy and that my rheumatologist said I should not take supplements because of my auto immune conditions and the fact that most of my blood work is actually okay.

I am on Evorel Conti patches. I’m not aware of any reason I’d be considered more at risk of osteoporosis than anyone else. The only bone breaks I’ve ever had have been my nose, a small bone in my hand and a toe. Only the bone in my hand would even be in my notes as the others required no treatment and that was when I was about 13! My mother did die of breast cancer but only one case in the family isn’t enough to be a “history” apparently which is why I can only have five yearly mammograms instead of the three yearly that I know some women get.

I’ve done some more reading today and it looks like the nurse who did my review had no idea what she was talking about!

@TheRoadToRuin Have a google? I did before posting and found loads of papers, some going back 10 years, others more recent. I didn't feel anyone would want to read them so I didn't link.

It's best to do your own research rather than relying on a GP as they are not experts on everything.

You don't need 1000mgs. 700-ish is enough.

A small portion of cheese, half a pint of milk and a pot of yoghurt, will get you there and if you don't enjoy/ eat dairy there are other options - green veg, tinned sardines, chick peas, salmon fillet, all have high calcium content.
The ROS has a very good list of calcium-rich foods.

@CouldBeOuting It's very strange and quite shocking that the nurse thinks this!

Why aren't you being called every 3 years for NHS mammograms?

If you can afford it, you can have private mammograms at most private hospitals. Costs vary but around £200.

If you have rheumatoid arthritis, there is an increased risk of osteoporosis but I expect your consultant would have covered that if it applied.

Thanks @JinglingSpringbells . Thanks, you've prompted me to investigate further as I do feel uneasy with the heart risk. As always you have to balance risks.
I have used the ROS a lot for information, great charity. I must admit I haven't looked into how much calcium they recommend and whether they still suggest supplements. Even as a none cheese eater those amounts are easy to achieve.

@TheRoadToRuin Quick google just now threw up dozens of papers. Hope it helps!

Here is one from 2022.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230596/

Conclusion - right at the end of it.

5. Conclusions

In this real-world, large-scale cohort study, the cumulative incidence and HR of acute myocardial infarction, ischemic stroke, and death increased with calcium supplementation compared with those observed without supplementation after adjusting for potential confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.Go to:

I don’t have don’t have RA. I spoke to the rheumatology department today and they said my conditions do not give any higher risk of osteoporosis- the nurse said she had no idea of my conditions anyway although I know they are on my notes.

I asked about the mammograms but apparently they are only five yearly now. I may well look into the private option thanks for that info (I thought it would be much more expensive than that)