Can HRT help prevent osteoporosis in women after menopause?

Question

Hello doctor,

I am a 52-year-old woman who recently went through menopause about two years ago. My mother had osteoporosis and broke her hip when she was 65. I had irregular periods for the past three years, and they completely stopped 18 months ago. Along with the typical menopause symptoms like hot flashes and mood swings, I am really worried about my bone health.

I used to take birth control pills for about 15 years, and I am wondering if that affected my bone density. I have also been experiencing some joint pain, especially in my wrists and lower back. My gynecologist mentioned that the drop in estrogen after menopause can affect bone health, but I am not sure what steps I should take now.

How does menopause specifically affect bone density in women, and when should I start worrying?
Should I get a bone density test, and how often should it be repeated?
Can hormone replacement therapy help prevent osteoporosis, and what are the risks for someone my age?
Are there specific calcium and vitamin D recommendations for postmenopausal women?
How does my history of birth control pill use impact my bone health now?
What exercises are safe and effective for preventing further bone loss?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Menopause usually happens gradually. The months or years leading up to menopause are called perimenopause or the menopausal transition. During this transition, the hormone levels produced by your ovaries fluctuate. Perimenopause can last between two and eight years, with an average of about four years.

These hormonal changes can cause symptoms such as:

Irregular periods.
Vaginal dryness.
Hot flashes.
Night sweats.
Sleep problems
Mood changes.
Trouble finding words and remembering, often called brain fog.

Menopause symptoms vary from person to person. Most often, periods become irregular before they stop completely. Skipped periods during perimenopause are common and expected. Periods may skip a month and return, or skip several months and then resume monthly cycles for a few months. Period cycles tend to get shorter in early perimenopause, so periods occur closer together. As menopause approaches, periods gradually get farther apart before stopping.

Bone density starts to decrease as oestrogen levels fall before menopause and continues to decrease after menopause. Lower oestrogen levels increase the risk of developing osteoporosis.

Osteoporosis is a condition where bones become less dense, making them more prone to fractures. On average, women lose up to 10 percent of their bone density in the first five years after menopause. About one in two women over the age of 60 will experience at least one fracture due to osteoporosis.

You can take the following medications:

Injection Cholecalciferol 200,000 international units: Mix with a glass of milk once a week and continue for one year.
Tablet Calcium carbonate with Cholecalciferol: Take one tablet at night for three months.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.