I am wanting some advice and information on HRT for the over 60s. I was refused HRT during my menopause in spite of then having osteopenia and no obvious risk factors for HRT- it was simply getting a bad press at the time due to some research (which was later found to be flawed). I’m now 64 and was diagnosed with OP last year. The idea of taking oral bisphosphonates scares me stupid and I can’t tolerate them orally anyway due to gut issues. Twice in the last week I have had doctors tell me that denosumab (Prolia) is the answer and I’ve had to point out that the Rheumatologist specifically told me that I was ‘too young’ to be put on that due to my life expectancy (based on my mother living to 98) and the fact that denosumab can only be prescribed for 10 years. I am normally fit and healthy and do a lot of cycling and walking. I have come across the view that HRT is a good treatment for OP even (some say especially) for the over 60s. I know of others who have been prescribed it at my age. I have spoken to a GP at my surfery recently who said it was not usual practice, but he did not dismiss the idea completely. He said he would look into it.
Are there studies that have been done into this or any evidence that might support my case for getting HRT?
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Annalu
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I think the issue with Prolia is not so much that it can only be taken for ten years as that you will have to take it for at least ten years as otherwise you will be vulnerable to getting fractures from rebound osteoporosis when it is discontinued. They may not know yet if there is ever a guaranteed safe time to discontinue it once more than one dose has been taken.
You have an active lifestyle. Walking in particular would be good for your bones. What do you do regarding supplements? It has been found that exercise and supplements can help increase bone density. Have a look at this article:
The other question I have for you is did your doctor run any tests to determine whether you may have what is called a "secondary" cause of osteoporosis, because if you do unless that is dealt with no medication or supplement will help. I understand that parathyroid issues are not uncommon. Once these have been ruled out, or treated if found, then whatever you choose to do will have the best chance of working well.
Thanks for that. I haven’t read the article yet, but did read your story, which was very interesting. I need to build up my walking and have been intending to look into Nordic walking. My maximum walking distance is about 4.5 miles (over 10,000 steps anyway) as the pain from my Morton’s Neuroma kicks in at about that point. I can carry on if I’m able to stop awhile until the pain subsides but on group walks there isn’t that opportunity.
Re denosumab, there does now appear to be some indication that 10 yrs is the max ‘life’ and once it is stopped the drop-off is pretty drastic. When I told the GP last week what the Rheumatologist had said, he looked it up and confirmed.
So far I have had two minor ankle fractures, a year apart and the same ankle each time. I have sprained this ankle a number of times in the past and thus weakened it further each time but it’s being treated as a ‘fragility fracture’ of course so the pressure is on to take the meds.
Ok, that's interesting about the denosumab. Apparently one dose is "safe" but more than one puts the patient at risk for rebound osteoporosis. Doesn't seem like that drug should ever have made it to market. But that's just my opinion of course.
I have had thyroid checked and all blood tests done. I have recently started taking calcium citrate alongside D3, K2, magnesium and boron. Trying to cover all bases really. I have IBS, so possible absorption issues.
If you have a problem with magnesium (it can cause diarrhea) you could try taking it in a different form. It can be absorbed through the skin so even an Epsom salts bath (or foot bath if you are a shower person) will help, and I believe there are also versions which can be rubbed on the skin.
Interesting article. I do have Epsom salts baths and have just bought a neck rest for the bath to make it more comfortable. I have IBS-D anyway but the magnesium glycinate doesn’t seem to make it worse.
Could you tell me where you found the info that Prolia can been taken only 10 years? I'm un the US and any time I try to pull up a site I get a redirection message and no info.
Hi Annalu I was diagnosed with OP April 2018 I had early hysterectomy age 39 but kept one ovary, around 48 I went on HRT as the sweats started, my mum had a fall broke her wrist so was sent for a dexa scan thankfully mum didn't have OP in chatting I mentioned my situation, was referred by GP for dexa osteopenia diagnosis carried on with HRT until I was around 57 when GP took me off it due to bad press, in between that time I was never called for another scan on a routine blood test last year I was very low in calcium GP just prescribed calcium I asked for dexa it was confirmed I had OP no HRT only alendronic acid I don't like it but terrified of breaking a bone as I have a son with learning disabilities and I can't afford to be out of action. Sorry for long answer I would be very interested to hear your GPs answer to your question. Good luck with whatever choice you make all I will say is I have two friends who were on HRT until their seventies and both have been diagnosed with Breast cancer it's so tough to make the right choice I wish you well.
Take great care with alendronate. I was on it 5 or 6 years. Then my thigh snapped when I was walking into the bus station. Apparently, alendronate hardens the bone. It doesn't strengthen it.
Well, yes and no! I have a pin from my hip to my knee. So it makes mri/ct scans difficult or impossible because of the metal. Haven't been abroad since, so not sure about the scanner at airport. Lucky both legs still the same length!
Hi. I am disturbed by your post. I have recently been diagnosed with OP even though I have played lots of sport through my life and walk dogs, every day, twice a day. I was really upset by the diagnosis. After researching it thoroughly, I refused to take Alendronic acid until the result of the DEXA scan was known. That took six weeks. Reluctantly, I have been taking it for a month now. No serious side effects that I can report. But if it makes the bone harder, more brittle, that is very depressing! I shall consult my GP again. But what else is there? Prolia doesn't sound good for me and I can't take HRT as both my mother and her sister had breast cancer. This is a minefield! Good luck to all.
I have remembered that my stepmother was on HRT after hysterectomy in her 50s probably, until she was diagnosed with breast cancer but she must have been in her late 80s by then. Taken off the medication. Passed away at age 92 with failed kidneys caused by an otherwise successful heart operation. I don't think this late diagnosis of breast cancer, which seemed to have been easily treated, would have been cause to deny her the benefits of HRT for thirty or forty years.
Read your post with interest, I'm not yet 60, don't want to take AA, want to explore other options, after reading your post looked up HRT on the NHS website and sadly it looks like it's unsuitable for me due to being treated, successfully, for breast cancer in 2013, never mind I'll keep looking
Have a look at My Osteoporosis Journey, a HealthUnlocked link posted in my first reply above. That may give you some ideas how you might proceed. Cheers!
I'm still researching my options, AA, which GP put me on isn't an option and from what I'm seeing on this forum all prescription meds comes with horrible side effects, unfortunately neither GP or hospital are bothered about me as they let me live my life for 5 yrs knowing I had Osteopenia and didn't bother to tell me!!!!
You can always ask for a copy of your dexa results from three years ago. The receptionist at your surgery will be able to print out a copy for you. It is your right to have copies of these scans.
I, too, am interested in HRT for treating osteoporosis. I am 58 and just diagnosed. My doctors have been declining to prescribe it to me as my both my mother and grandmother had breast cancer. I am willing to take the risk though. I found this article which I thought was helpful: endocrineweb.com/conditions... - it seems as this was a popular treatment for OP until the new prescription drugs came out.
I have asked my doctor to reconsider prescribing it to me as I am declining the usual prescription drugs. Meanwhile, I have started on some recommended supplements and upping my exercise regimen.
Right!? I sent the article link to my doctor. It makes me mad that they won't prescribe what I asked for. And Like Susie says below, had to keep bugging her doctor over and over till they did. I am going to keep bugging my doctors as well!
Thank you for that endocrineweb.com link. What a wealth of information! I shall definitely approach my GP about this. Is the risk of breast cancer worth it, do you think? My mother and her sister both had breast cancer - my mother in her 70s. I am 71, but might be willing to give HRT a try.
For myself, I am willing to take the breast cancer risk to protect my bones but I still can't get anyone to prescribe it. I tried my gynecologist and she wouldn't put me on HRT either. So, I am not having any luck with my doctors! My mother had breast cancer in her mid 60's but died from colon cancer a few years later. Colon cancer scares me the most. I hope you are able to have more luck with your doctors than I have.
I'm 71 and my doctor prescribed me HRT a couple years ago, because I have osteoporosis and I refused to take any of the awful bone meds....I think they should all be taken off the market, due to the horrific side effects they cause. My doctor hesitated prescribing the HRT for me, but I just kept bugging him about it...emailing him...mentioning it to him when I would go in for an appt...he finally agreed with me! PHEW!!! So...you may have to find a doctor who is more open minded. A lot of them still believe that awful flawed study back in the day...and it's a real shame....good luck...keep us posted.
Hi, Annalu - I had a dexa scan in 2015 and there it was...osteoporosis. However, I've never had a fracture and will take my chances with the HRT, as there is no family history of breast cancer in my family. My doctor is pretty open minded and I am so glad to have found him. I also have a friend in Wyoming who's doctor allows her to take it and she's going to be 70 in October...so there are a few doctors around who are not afraid to prescribe it. I hope you can get it prescribed, but even if you cannot..please do not let these doctors talk you into any of the bone meds!! They are the true killers of quality of life for many, many people....
There’s no way that I will take the bisphosphonates. As I said, the GP that I saw was not unsympathetic, though perhaps a bit sceptical that HRT might be a good option for someone my age - or at least as good an option as the bone meds (which the medical profession in general seem to have bought into). Another question, are you in UK and trying to get meds on the NHS?
No..I live in the United States, so don't have to deal with the NHS..although, here in the US, we don't get much of a break on the cost of meds. My HRT costs me $47.00 a month at the very least and can change at any time...same with my other meds....
I would also like to get prescribed HRT but GP will not even consider it due to my being 64 and 10 years post menopausal. Had ovaries removed when I was 50 due to history of ovarian cancer in family. I was given no diet or supplement advice and not prescribed HRT then due to cancer in the family. So basically nothing to help me and I now have osteoporosis in spine -3.8 in 2 vertebrae. I’ve had 3 spinal fractures but am still resisting the meds. When I asked my Rheumatologist about HRT she said it wouldn’t be prescribed as I’m post 60. She also said she couldn’t understand why I’d be prepared to take HRT with the risk of cancer but not take the osteoporosis drugs. For me anything that will possibly have an adverse effect on my daily living and lifestyle is out, I’d rather take my chances. I’ve heard too many stories of people being effected on a day to day basis by nasty side effects. Also the risk of cancer from HRT is relatively low even for someone already with a cancer risk. I’ve heard that the patches carry less risk of developing cancer too? I have read it can really help osteoporosis so I wish you success with it and would be really grateful if you would please let me know how you get on?
Hi Debs, I’m 14-15 years post menopausal too. Have you seen the stuff written by John Studd? He’s a Professor of Gynaecology who runs a (private) menopause clinic. My GP was a bit sceptical about Studd because he’s in private practice and so basically in the business of selling HRT. Here’s an example of what Studd has to say: studd.co.uk/hrt_today.php I’m not due to see the GP again for a while (he is going to look into it for me, but had some holiday coming up too) but I’ll let you know how I get on.
Interesting reading. I had a full hysterectomy 20 years ago and took HRT for a couple of years. No one told me that stopping HRT could cause me osteoporosis, I was diagnosed Oct last year. I am now 61, I have managed to persuade my GP, after numerous requests, to prescribe me a HRT patch as I refused the bone medication.
I feel let down that I wasn't properly informed about firstly having my ovaries removed when I had the hysterectomy, and secondly about the affects of not taking oestrogen. I hope that my T scores improve, -3.5 at the moment, but I feel that this is a big ask.
That John Studd article is really interesting and may even be something life-changing, for me anyway. Good luck with your doctor and please let me know how you get on. I am definitely going to take it and see my GP. Thank you.
And yes it’s the impact on daily life that bothers me with bisphosphonates - sickness, nausea, aching, bone and joint pain and so on - plus the idea of bones getting ever more brittle.
Yes, absolutely. Thanks for that link Annalu. Due to see my GP next month so will be helpful to quote but not overly hopeful as my GP is very kind and sweet but tends to go by the rule book. I switched to her recently because I saw that she’s interested specifically in women’s health so you never know! Thanks again, good luck and please keep me posted.
Likewise - let me know how you get on. My OP isn’t so far advanced: -2.7 spine and still within osteopenia range elsewhere but I’ve had two very minor fractures in my ankle so the pressure is on to take the meds. Good luck.
I will be happy to. Without meaning to alarm mine was that 5 years ago so I’m worried about how quickly it’s deteriorating. I’ve been very unlucky and had 3 accidents in that time and I’ve been told the -3.8 is in two of the vertebrae that fractured. Think the average is -3.4 in spine. Only osteopenia elsewhere which interestingly has stayed the same 🤷♀️Have had a better supplement regime in the last few months so 🤞 also had lots of stress and suffer from insomnia and that is definitely supposed to be bad for bones 🙄 going to try and chill more in future. Easy said!
Good luck with the next scan. You should be getting them about every three years. I’ve just booked an ultrasound bone density scan which is supposed to be more reliable than DEXA and doesn’t involve radiation. I’m in an OP group on Facebook and there was a special offer for the scan plus a brief consultation on the results. I figured it was worth it. If you’re on FB I can send you a link to the group and the post.
I have IBS and other gastric issues which can affect absorption of vitamins and minerals plus I’m prone to anxiety and stress too. I’ve also done a lot of cycling which is excellent cardiovascular exercise but not weight-bearing. Apparently cyclists often develop OP in the spine.
Thanks, I had a scan last October and apparently will get another one in 2020 but I like the idea of the ultrasound one in between I think. I say I think because sometimes I’d just like to get on with my life and not know 😉 Have you had yours yet and if so how did it go? I went to my GP yesterday and predictably she was urging me take the drugs and telling me that her patients rarely reported side effects other than the acid reflux and nausea. Surprisingly though, after I explained my reasons for being resistant to them she agreed HRT would be better than nothing. She showed me the risks and must admit I was a bit scared by the charts she showed me. She was very reluctant saying that she wouldn’t prescribe it under normal circumstances and that it is only because I’m refusing the drugs and need something that she is prepared to. There is a lot of cancer in my family! She said the gel or patches have less risk and that it will need to be taken with progesterone which can be taken orally or something which is a milder form of progesterone can be inserted into the womb 🤷♀️ never heard of that one! Anyway, we left it that I will think about it and get back to her. I thought I would jump at the chance and think I will give it a go but lots to think about....
They are based in Coventry, but are running a few clinics elsewhere in the Autumn: Solihull, Bradford, Lincoln, Olney, London, Northampton and Orpington. Cost £125 if booked before 1st September, £150 after that. Call 07866 427530 for further information/to book your scan or email sarah@osteoscanuk.com
The company using the EchoS bone scanner, Osteoscan UK, is actually based in Northamptonshire, where there are regular appointments available. It was set up by Mr Nick Birch, orthopedic consultant, together with Karen Grinter (pilates instructor with specialist bone health training). Nick has been taking the equipment to other venues, with a 2nd base, as you say, in Coventry. See northantspilates.com/blog and mybonehealth.co.uk/ (the latter is under construction, but has a contact phone number on it).
Hi. I'm 65 years old and have been ardently anti medication since my Osteoporosis diagnosis in 2016. After a complicated further wrist fracture, had another bone scan and my spine has deteriorated a further 17% to -4.2. My recent visit with a rhematologist resulted in him agreeing with my instinct drawing me towards taking Strontium Ranelate if I had to take something. I also said I'd read that progesterone can help bone density. He agreed and said take the SR first and then the progesterone.
My GP says that estrogen should be given with the progesterone and he is happy to prescribe it. I had HRT in my early 30's and it ruined my life. It was prescribed for severe PMT. My whole metabolism was messed up, I had severe breathing difficulties, awful fatigue, could not function and I was medically retired from my career. I was told later that if full dose was given to any healthy body that didn't need it, the result would be similar. Hrt was fairly new in those days and considered the next best thing to sliced bread.
Later I took progesterone only, the mini pill which stopped my periods completely. This was great, no side effects except the long term osteoporosis which I was not aware of at the time. I'm past menopause now so perhaps if I take hrt it may help instead of harm me.
GP surgery has lost the specialist's letter so I'll take my copy to the surgery today. I'm terrified of any chemical treatment and have an appointment next week. If you're interested, I'll keep you posted. At least you know HRT is still being prescribed in some cases to over 60's. xx
Doesn't help , but thank you so much!. I didn't know what that was either . I finally went off line and looked it up. I have never had hormonal issues and I was passing through menopause and never had to stick my head in the refrigerator like my friends. The blood test was the only way I found out. So my OP and hormones never met.
As an update to my original post re HRT. A month ago I saw a GP I’d not seen before. I asked about HRT and he gave me all the usual stuff about age (I’m 64 and never had HRT) but said he would look into it further. I have an appointment with another GP next week (rarely get to see the same one twice). A few days ago I looked at my Patient Record (which I can access online) and found this note:
“History: Task from Dr ______ - patient asking about HRT for treatment of osteoporosis.
Age 64, no previous HRT.
Initiation of HRT above age 60 has increase in risk of cardiovascular disease and stroke
Risk of fragility fracture is reduced whilst taking HRT. However, benefit decreases again once HRT stopped.
NICE guidance is to co-prescribe HRT with standard osteoporosis management to younger post menopausal women as fracture reduction with long term use.
As the risks of HRT outweigh the benefits over age 70, she would only have a short time of taking HRT so will gain little long term benefit.
Plan: Discuss at appt.”
Now, to me that sounds hopeful - as if they may at least agree to prescribing it for 6 years (and who knows what may change in that time). What do you think? Any advice on how to proceed? (Of course stocks of HRT are very low here in the UK at the moment and expected to be do until spring 2020).
I am in the US and read questins and replies referring to HRT. I may sound stupid but would you please explain what HRT is?
I have never had an issue with hormones, and did even know that I had passed through menopause until a blood test was done and I was informed by the doctor. But I do have osteopenia and on my first annual Reclast infusion. Am treated bythe rheumatologist at the medical school at a large university.
Thank you very much. I finally went off line and looked for it. I was feeling so stupid.
I never had a hormonal issue with menopause. I never new when I was going through that when my friends were sticking their heads in refrigerators. A blood test finally verified that all was ok and I was spared the need for that therapy. Not a single cramp or hot flash. No nothing.
So my hormones never met my OP. Sometimes one gets a gift.
Thanks for reminding me to update. I was refused HRT , because it's not a treatment for osteoporosis and I'm too old for HRT anyway. I was told (again) to take Prolia/denosumab.
I took alendronic acid - fosamax in USA - for probably more than 5 years until 2014, when my left femur broke because of the pills. Stopped taking them, obviously. SIX years later, I stood up to get off the bus, and my right femur broke, told same reason. But I still can't have HRT. Just calcium and vitamin D. And now I have depression and osteoarthritis in my spine and fingers, leading to my shrinking and difficulty using my hands. What can I do??
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HRT stories?
HRT and Seniors
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osteoporosis and spinal fractures
