Can HRT help prevent osteoporosis in women after menopause?

Question

Hello doctor,

I am a 52-year-old female who went through menopause about two years ago. My mother suffered from osteoporosis and broke her hip at age 65. I have had irregular periods for the last three years and they stopped altogether 18 months ago. In addition to the usual menopause symptoms of hot flashes and mood swings, I am also very concerned about my bone health.

I was on birth control pills for about 15 years and wonder if that affected my bone density. I have also been experiencing some joint pain, mostly in my wrists and lower back. I was told by my gynaecologist that the drop in oestrogen after menopause can affect bone health, but I don't know what to do now.

What does menopause do to women’s bone density and when should I start to worry?
Should I have a bone density test and how often should it be repeated?
Does hormone replacement therapy help prevent osteoporosis? What are the risks for someone my age?
Are there special recommendations for calcium and vitamin D for postmenopausal women?
How does my history of birth control pill use affect my bones now?
What are safe and effective exercises I can do to prevent more bone loss?

Please help.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Menopause generally happens gradually. The years leading up to menopause are called perimenopause, or the menopausal transition. During this time, hormone levels produced by the ovaries begin to change. The transition to perimenopause can last anywhere from 2 to 8 years, with an average duration of about 4 years.

These hormonal changes can result in symptoms such as:

Irregular periods
Vaginal dryness
Hot flashes
Night sweats
Sleep problems
Mood changes

If you have trouble remembering things or finding the right words, it is often referred to as brain fog.

Menopause symptoms vary from person to person. Periods usually become irregular before stopping completely. Missing periods during perimenopause is completely normal. Your periods may skip a month and then return, or they may stop for several months before becoming regular again for a short time. In early perimenopause, menstrual cycles often become shorter and closer together. As menopause approaches, periods become less frequent until they stop altogether.

Oestrogen levels begin to decline before menopause, causing bone density to decrease. This bone loss continues after menopause. Lower oestrogen levels increase the risk of developing osteoporosis.

Osteoporosis is a condition that causes reduced bone density and increased bone fragility. On average, women lose up to 10% of their bone density during the first five years after menopause. One in two women over the age of 60 will experience at least one osteoporosis-related fracture.

You may take the following medicines:

Cholecalciferol 200,000 international units injection: 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 3 months.

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

Thank you.