Osteoporosis Prevention: Is HRT still a viable option?
menopause, osteoporosis and hormone replacement therapy - by Ed Main
Osteoporosis is an increasingly common risk in the United States. The chances of a 50-year-old woman breaking a bone due to bone density loss or osteoporosis are between 40%-50%. For most women, bone density loss begins during the years leading up to menopause, known as perimenopause. In the decade following menopause, bone mass loss accelerates to a rate of 3% per year on average.
Until recently, Hormone Replacement Therapy (HRT) was commonly prescribed as a method to alleviate the challenges of hot flashes, night sweats, anxiety and other effects of menopause. In addition to this primary purpose, HRT was used to prevent and partially reverse the post-menopausal bone loss that leads to osteoporosis. Because of this added benefit, it was not uncommon for women to remain on hormones for an extended period of time, sometimes for decades.
In 2002, WHI findings led the medical community to revise its views on prescribing HRT. Currently, many major health organizations, including the American College of Obstetricians and Gynecologists, the American Heart Association, and the North American Menopause Society do not recommend the extended use of HRT as a method to prevent chronic conditions such as bone density loss. Physicians are now recommending alternative approaches and medications such as bisphosphonates, calcitonin, parathyroid hormone and raloxifene to prevent osteoporosis.
Hormone Replacement Therapy, however, has not been abandoned in its entirety, either as a way to help women address menopause or as a tool for osteoporosis prevention. HRT is now prescribed in lower doses and for shorter periods of time. In addition, the benefits and risks of using HRT are assessed individually, within the context of a woman’s own medical condition and family history.
While you do need to check with your doctor regarding the best approach for your particular situation, one thing has remained consistent throughout this period of HRT scrutiny: having a first line of defense against osteoporosis. This recommendation includes an overall balanced diet that includes adequate calcium, vitamin D and other selected nutrients, coupled with appropriate weight-bearing exercise.
Information Links:
Medications to Prevent and Treat Osteoporosis from the NIH
The National Osteoporosis Foundation
a ready source of information on osteoporosis, prevention, methods, medications and treatment
Menopause: Managing the Change of Life
A 2006 Harvard Medical School Special Health Report covering a number of topics including:
Hormone's: What To Do Now? | The Signs of Perimenopause | Healthy Living at Menopause
ACOG Statement
The American College of Osteoporosis and Gynecologists' Statement on Hormone Therapy for the Prevention and Treatment of Postmenopausal Osteoporosis
Postmenopausal Hormone Therapy and Cardiovascular Disease in Women
American Heart Association's Questions and Answers
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