Hormone Replacement Therapy (HRT) and Osteoporosis
Bone mass begins declining in most women in their mid-thirties
There is a misperception that osteoporosis begins at menopause. In reality, bone mass begins declining in most women in their mid-thirties and even earlier. It accelerates for 3-5 years around the time of menopause, and then continues to decline at the rate of about 1-1.5% per year.
Estrogen Replacement-Not the answer
Because bone loss accelerates at menopause, and because estrogen levels decline at menopause, conventional medicine has adopted the belief that osteoporosis is an estrogen deficiency disease that can be cured with estrogen replacement therapy and remains the standard medical approach for osteoporosis.
The Key - Progesterone, diet and lifestyle
The missing piece of this puzzle is diet and lifestyle, plus the bone-building hormone progesterone (natural progesterone), which drops much more precipitously at menopause than estrogen does.
Very few women need to take estrogen for osteoporosis.
There is no question that estrogen can slow bone loss around the time of menopause, but the scientific evidence is very clear that after 5-6 years, bone loss continues at the same rate, with or without estrogen. A very large study published in the New England Journal of Medicine in 1995, studying risk factors for hip fractures in white women, which followed over 9500 women for eight years, found no benefit in estrogen supplementation in women over the age of 65. If estrogen was the only known treatment for osteoporosis, it might be worth taking it to get the small saving in bone density, despite all the risks and side effects. But since it's clear that progesterone, combined with proper diet and exercise, steadily increases bone density regardless of age, there are very few women who should ever need to take estrogen for osteoporosis.
Women who need estrogen tend to be those who are petite, slim and small-boned. After menopause, a woman’s fat cells make estrogen, but a slim woman may not be making enough to keep up with bone loss. Those women may need a very low dose of estradiol.
The problem with pharmaceutical drugs:
Fosamax
There are a number of pharmaceutical drugs being used to treat osteoporosis, none of which work very well, and all of which have unpleasant side effects. One of the best known is fosamax, a biphosphonate drug that can slow bone loss. Unfortunately, the old bone which is saved by using fosamax is eventually structurally unsound, and after three or four years it has no benefit, and I suspect it tends to increase the rate of hip fracture after about five years. For a while fluoride was being touted as an osteoporosis drug, but like fosamax, it only slows bone loss temporarily, and the long-term consequence is an increased rate of hip fracture due to structurally unsound bone.
Calcitonin-salmon (Calcimar)
Another conventional medicine osteoporosis drug is called Calcitonin-salmon (Calcimar). This is a hormone made by the thyroid gland that cantemporarily slow bone loss. Again, the long- term side effects are not well known, and its effectiveness diminishes rapidly after a few years.