I'm convinced HRT is worth a try for me to help protect my bones and possibly other things even at my age, so want to go and have an intelligent conversation with my GP and not get fobbed off because I am too old (63 and way past menopause).
When I first enquired about it in my early 50s there was a cancer scare and GPs were reluctant to give it and actually taking women off it, but my understanding is that advice has now changed and there are different options available. I have had catastrophic spinal fractures recently and want to do my best to stop it happening again. I'm on Romo but that is only for a year and after that I presume they will suggest annual Zoledronic infusions but I personally don't think that's enough.
Please share any info re what types have worked for you etc, all info gratefully received. Was your GP amenable to it?
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tangocharlie
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Well, I'm a little past the HRT thing, but do feel that Zoledronic infusions are not enough. I cannot afford Romo and since I started on Zoledronic infusions, I can't get covered for Romo here in Nova Scotia (or so says my Osteo specialist). I think she could probably write a letter that says I meet the criteria. I have a phone consult with her tomorrow and will ask that question. After a year since my first infusion (second one scheduled for next week), I'm still fracturing, so the efficacy of it is lost on me and apparently I'm not due for another DEXA as we can only get them every 3 years now. As usual, I get that fobbed off feeling. Hugs TC.
Keep going, I heard a useful phrase which is going to be a new mantra for me now "Be a pain in the bum til something gets done". PS I don't know, and probably it isn't known even unto doctors, but I think HRT might help at least some people whatever age. I'm not accepting what one doctor said to me that HRT is pointless after the age of 60. When I said How do you know? she couldn't give me an answer
I went through an early menopause at 47 and wasn’t offered HRT and like you didn’t pursue it like you re the cancer scares!
Consequently I now have osteoporosis and have had a spinal fracture and a spinal compression fracture 😢 my dexa scan showed -2.6 hip and -2.5 spine which are boarderline but must be bad for me to have had fractures.
I’ve often wondered if I could start HRT now and would it make a difference? I will be interested in any comments too TCxx
In another of my posts a few people mentioned they or someone they knew was on HRT at 70+ so I am very keen to hear more. A generation of us missed out on HRT for a decade and I'll bet the repercussions are coming to light now. You've probably heard me mention it before but for others and for the record, my DEXA scans were always fine, not even -1 so my fractures came completely out of the blue, I thought I was safe
I am 78and only this year have been put on hrt pesseries after a lot of trouble dien below will carry on for as long as i can as problems now much better
Hi Tangocharlie, my mum started HRT gel two years ago at age 73 for bone protection, insomnia and wrist pain. She went through menopause at 52 and tried HRT for 6 months then but gave up as she emigrated.
She’s doing really well. She has osteoarthritis and her doctor believes HRT could slow its progression - we can’t measure this but I hope it’s possible. She gets much better sleep now, her wrists are pain free and her skin is no longer dry.
My friend’s Mum is 87 and has been on HRT for 20 years, she’s one of the fittest women I know!
I think it’s really worth discussing with your GP and if that’s a no go look into menopause specialist.
I'm also want to have a serius conversarion with my Doc. I'm 63, early menopause at 40, and also no HRT afraid of cancer. Now doctors say it is to late. But reading all of you today, it may be an opportunity. I've heard that are several types of drugs for HRT. Wich one is more indicated?
Hi Verauk, I really don’t know but I think that transdermal oestrogen is recommended opposed to oral. Micronised Progesterone needs to be taken with oestrogen if you have a womb. I use Oestrogel which I rub onto my thighs daily, my Mum uses the same. Good luck with your GP.
Many attitudes and beliefs about HRT are still based on the 2002 WHI study which made erroneous conclusions about heart disease, cancer age etc. There are several recent studies on HRT that shed new light and understanding. I am 67 and started BHRT with Progesterone 4 months ago. I found an excellent naturopath specializing in menopause and certified by the NA Menopause society who prescribes the BHRT. She enquired about my cholesterol, blood sugar, weight etc. and suggested getting a coronary artery plaque scan done which I did. Based on my present health, the naturopath said she had no concerns and that my arteries were like a younger woman's and would be quite receptive to estrogen still. She said confidently that this would stop further progression of bone loss and possibly gain back a little bone, but if there were any gains, I would lose them if I stop the HRT. My spine is at -3.5, but I am so fortunate not to have fractured yet. I know this alternative treatment may be a gamble, but I wish to avoid the harsh OP medications if at all possible. I had a REMS bone scan done which showed my bone quality on the border of good quality still and am seeking a DEXA with a TBS to measure bone quality as well. I feel good on the HRT with unexpected positive benefits such as a better sleep and general calming effect on my mental state. Amazing! I hope you find what is best for you.
Bioidentical hormone replacement therapy. I use the transdermal patch (Estradiol) which bypasses the liver so is safer. I am about 14 years past menopause. I forgot to mention I live in British Columbia, Canada.
Are you in the UK Coffee56 ? I've never heard of such a plaque scan and REMS isn't availalbe anywhere in my part of the UK, or even recent DEXA scans that can do trabecular. So you are very lucky to have had all that. Thans for the info and wishing you continued good health
No I am in British Columbia, Canada. I'm surprised REMS isn't available near you as they are much more available in Europe than in N.A. and have been for longer. I've read posts on other sites from people in the U.K. who have had one. Some doctors here haven't heard of them. I had to fly to Alberta for one. I had to pay for the coronary artery scan privately. I wish you all the best.
I had a REMS scan at the osteoscan main centre in Northamptonshire, but for my next one I'll use the mobile clinic in York where I live. Can't speak highly enough of them!
I did see a webinar on the ROS website where various OP treatments were discussed with experts including HRT. The outcome was that if you’ve never been on HRT and are way past menopause you shouldn’t try it. However the above members are testament to it working and them feeling better. Perhaps the ROS moderator could point you in the right direction for this webinar? As I now have bursitis in both hips, as well as spinal fractures, all as a consequence of a lack of hormones I certainly wish I’d taken HRT at menopause but was scared off by reports of links to breast cancer at that time - I’m 69 so talking 20 years ago.
Yes thanks I think I saw that but I don't accept it is too late, maybe that opinion is now outdated? I don't know but am trying to find out. One of my rheumatologists said there was no benefit of being on HRT after 60 and when I aid How do you know? there wasn't time to discuss it. I haven't found any any recent research on it yet. And I am getting plenty of people writing to me saying they are benefitting from HRT into ripe older ages. So I'm still thirsty for knowledge.
I started HRT 3 years ago when I was aged almost 64 and 14 years after menopause. At the time, I was also taking alendronic acid, which I discontinued about 6 months later due to side effects.I'm due for a dexa scan in December, so it will be interesting to see that result compared with the dexa of 3 years ago.
I too have found that HRT has helped me to sleep better. It also put an end to the palpitations (ectopic heart beats) that I'd had on and off for nearly 20 years.
Good Morning, your post has really brightened up my day, thank you! My Mum suffered with palpitations that were causing anxiety and doesn’t now. I’m really interested in your DEXA scan too, I’m high risk for osteoporosis (long term hyperthyroidism) and awaiting DEXA results. I really hope your results show no progression and even better would be repaired density - Good Luck!
I don't know waht to thnk about DEXA scans given that 2 showed me I was absolutely fine but then I got fractures anyway. In themselves they don't give a full picture and it seems can give false positives. Ther are so many different methods of bone protection not just AA which is hte most basic so it's be worth you reading the stuff on the ROS website and talking to the ROS nurses to see what they say. Fantastic news re your sleep and palpitations. because I'm on steroids insomnia is often a problem. But I understand sleep is more problematic after menopause anyway so it's great it helps that. Sleep is a fundamental pillar of health to get right
Hi this is such a interesting post. I'm 62 and had spine fracture which has not healed in over a year so they put me on Teriparatide injection daily to try and build some bone density I've been taking it for just under a month a tolerated it ok. I too am going through a horrendous time with night sweats insomnia irregular heartbeat a d severe wrist and thumb pain which is pretty unbearable ATM. Funny enough my doc said at 62 try hrt but as I was about to start Teriparatide they could not give an answer if both together would be OK. So bottom line after Christmas I may look into starting hrt as well to try and sort these other issues.. like you it feels very scary and all the horror stories are off putting but I guess like every drug it's a gamble and about quality of life. HAS ANYONE ON HERE BEFN ON HET AND TERIPARATIDE TOGETHER thanks in advance and I hope you find a solution soon. By the way my osteoporosis is classed as severe with - 4.7 t score in spine. Xx
Worth asking that as a separate post as that is also one of my questions. I am on Romosozumab aka Rom or Evenity and will take that for anoher 10 months so don' know if I want HRT at the same time. I suspect yes if I am in still in danger of further fractures, the more the better. I doubt the docs even know as Romo is quite new and so is putting women on HRT at our age and beyond
I started on bio- identical (b)HRT early this year at age 74. My rheumatologist suggested that or denosumab for my osteoporosis. I take the oestrogel (gel) but only one pump instead of two as I had breast tenderness and uterine discomfort on the higher dose. I take 100g Utrogestan at night which I find helps me sleep though I do still wake up in the early hours even with 2mg slow release melatonin and magnesium citrate.
I feel I have some benefit from it though my bone density has continued to go down. Maybe the full dose would prevent this or maybe my bone density would have gone down even more without it. (I am on long term steroids).
I plan to continue to take it even once I start on ?denosumab in the hope it will help on the bone building side. My rheumatologist was ok with this. I do wonder about seeing a specialist in female hormones to ask whether other hormones eg DHEA or testosterone should be considered as part of the picture. I know many years ago my DHEA was non existent but nobody seemed bothered.
personally I'd suspect you would be eligible for Romosozumab as like me you are deemed high risk of fractures being on steroids. Has that been discussed with you? I need to research more about bio and bio identical as don't know anything yet. Sorry I don't know what DHEA is yet eiehr, I'm on a steep learning curve
Tangocharlie I am in exactly the same position. I am mid sixtied and found out last year I had osteoporosis. I had a fairly early menopause and at the time as you say, HRT was a complete no-no. My mother had osteoporosis too and so nowadays I imagine I would have been offered HRT. I think there is a large loss of bone density in the years immediately following menopause which might be why HRT maybe not suggested after 60? But these replies are really interesting - I have had rubbish sleep (wake v. early and can't get back to sleep) and hip bursitis and now shoulder tendonitis and wondering if HRT might help all those problems. I never knew there was a bursitis/tendon issue connection with lack of oestrogen. For the osteoporosis maybe HRT might still help stop it getting worse - though I am taking alendronic acid for that.....But am thinking the GP will probably say no....
How did you discover the link between bursitis/tendon issues and lack of oestrogen? Is there research on it? If so, if you have a link I'd be grateful if you could post it please. I'd love to read more about it.
Hi Hoofprints it was mentioned earlier in this post but in terms of scientific evidence..... if you Google 'menopause tendons' or 'menopause bursitis' you will find lots of sites which talk about how lack of oestrogen impacts tendons but I can't find an NHS authority on this (NHS sites tend to be more evidence-based). There is a paper which found that HRT helped bursitis but it is just one paper.....
Thank you so much. I really appreciate that. Although I think my condition was around undiagnosed/misdiagnosed for years, I had no bursitis before peri- menopause and got a lot iller a year after menopause. My oestrogen level was aleayhigh naturally when tested mid cycle and I think it would be real progress to adjust doses in post menopausal women by taking into account what their normal/natural levels were.Nature does not favour women (and not does most medical research seemingly!!)
I too have bursitis and was told by my GP that it’s very common in women my age (69) due to lack of hormones. Would be great if HRT helped with that too
That's interesting. My bursitis started in my perimenopausal years, around 46/7 years old. Mild at first and only one side,but GP fobbed me off with physio and so it wasn't diagnosed back then.However, my autoimmune small vessel vasculitis went undiagnosed for at least 18 years and bursitis can also be a part of that too, so who knows why it got so bad when it did.
I'm sure the drop in my hormones has made things worse though. The menopause is so hard for some women, less so for others. My perimenopause was a horrible drawn out period too!
How did you discover the link between bursitis/tendon issues and lack of oestrogen? Is there research on it? If so, if you have a link I'd be grateful if you could post it please. I'd love to read more about it.
There may be something there as I - maybe by coincidence or maybe not - had frozen shoulders and trochanteric bursitis around the start of menopause at the age of h50 which somehow morphed into PMR, and that is a common path with us youngsters who get PMR. There have been papers written on those types of bursitis being diagnostics for PMR but I havent seen anything to link to changes in hormones, though to me is seems highly pausible. Any ideas @PMRPro?
Hi, I'm a runner and have had a bit of tendonitis due to over-doing it. Apparently, tendons are made up of collagen and collagen needs oestrogen. From reading these posts here, I think I'll discuss trying HRT with my GP rather than going straight on to Alendronic acid which she's encouraging me to do. My hips have no osteoporosis but my spine is osteopenic (T -1.25) I had some small fractures this year in my pubic bones after a significant fall which is why my GP wants me to take the medicine! Although I fell heavily on to my lower back, I suffered no vertebrael fractures. I'm 68 and also in that generation that were discouraged from HRT due to cancer scare.
With reference to collagen, when I broke my wrist I was told to take Vitamin C. It's important for collagen formation when healing from a fracture - the precursor to bone!
Hello there. I am 77 with spinal fractures and if I could tolerate HRT (very severe side effects) I would not hesitate to take it for the rest of my life. It is time that we asked (demanded) that GP's give their views in an evidenced way, not just on a whim. We should be more assertive and have done our homework re research ready for our appointments with GP's. It helps to remember that they have to know a little about a lot and that includes osteoporosis and HRT. Go for it! Good luck.
Thanks, that's exactly what I'm trying to do, be well informed so I can ask the right questions and challenge attitudes if I just get 'computer says no' PS may ask what side effects did you get?
Hi again. I had endometriosis and adenamysosis which causes very painful bleeding into the muscle wall. Despite a brilliant Consultant it just was not feasible for me to continue. Good Luck!
Not sure if this is helpful but might be. My Mum has her estrogen levels checked annually by her doctor, she’s in France and healthcare seems to be better than I get in the U.K. They aim to keep her estrogen level over 300 pmol/L for bone protection. I can’t find any research which backs up this figure but I’m new to learning about osteoporosis.
I have moderate osteoarthritis and saw a surgeon earlier this week, he told me that estrogen deficiency is the reason he does far more hip replacements for women.
I managed to persuade my GP to do an estrogen test earlier this year so the NHS does them.
I feel like you read my mind TC. Ive been wondering this myself after my bad Aclasta infusion and worried about having to go on Prolia, etc. in a few months. I didnt get in with hrt years ago but there are more natural up to date ones now i think. I think i will certainly look into it. Im 65 but ive heard recently of someone in their 80s going on it.
Hi TangoCharlie. I have been on HRT in the form of both very low dose compounded estradiol and testosterone creams for a good part of my post menopause (age 55) years. Now almost 69. Last DEXA scan almost 2.5 years ago, was in the range of -1.3 to -1.4 for overall hip and spine. Femoral neck just at osteoporotic, but since it is a very small area and subject to error, think it is probably not really quite correct. My dose is less than the lowest dose patch most readily available here in US. Menostar is the brand here that is equivalent to my cream, but it is very pricey. Think my reasonably good density is attributable to decades of running, walking, and weight training and perhaps the HRT. For the past 2 years I have done a decent amount of vibration plate training and since March have engaged in jumping and skipping per the book Next Level.I broke my wrist walking at a good clip over 7 years ago, but it was from slipping on a wood bridge (not a fragility fracture). My doctor tests my hormones about 1/year and my levels are high normal for post menopausal. I am trying to only slightly bump up my hormone levels based on a JAMA (I am in USA) article I printed many years ago that stated this minimal HRT could help bones. I also take progesterone pills for ~ 12-14 days about every 4-6 months as a suggested precaution against uterine cancer. Hope this helps you.
Thank you, a lot of info to take in there as I'm new to all this and things works a bit differently here in the UK but it will all be a useful part of my research so thank you and keep on doing what you're doing if it's working well x
I'm 63, been on Bio-identical hormones since 51. The dose for estradiol was too low, a mistake by ANP, at least she admits it. I have had 10 fractures. Got the dose corrected and my density has improved dramatically with added Tymlos injections. I take compounded only, no pharmaceutical hormones. I use estradiol, progesterone, testosterone...estradiol is the best form of estrogen. I go to a hormone specialist as my Gyn was quite clueless...some of the ANPs get extra training, and mine is very up to date. I can tell you my strength has improved, energy, sleep is better, and no more brain fog. They have made a tremendous difference. My Rheumy was relieved I was on them, she says there is so much bad info on hormone replacements out there...the dangerous ones are from pharmaceuticals, not the compounded with natural ingredients.
Thank you very much for that info. I will watch that and I have also been recommended this book by a couple of friends who are on HRT and doing great. Her credentials seem very reliable, in fact she seems an outstanding authority on the topic
I had oral hrt for 5 yrs at menopause and then told I must come off it. I researched it very thoroughly 18 months ago. Most accelerated bone loss occurs in the first 5 years of meno. so yes that's the magic window. It seems clear the cancer risk is minimal with transdermal hrt. Less than if you were obese.Latest scare is that it 'might' increase dementia risk if started after the ten year magic window. However, the studies were observational not controlled trials. The Alzheimer's Society felt no conclusions could be made. Over the years dental fillings and numerous other things have been cited as precursors. Evidence/advice changes all the time.If you want hrt you might have to say you want it for menopause symptoms. I started it at 68yrs. One year in no problems so far.
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Osteoporosis and HRT for the over 60s
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