Osteoporosis is when bone loss occurs faster than the body can replace it. One in 3 women are at risk and 1 in 5 men are at risk of bone loss. There is a link between bone loss and hormone imbalances. This is not an aging issue alone, as younger people are also at risk. Awareness of individual risk from a young age can help prevent this progressive disease.
The link between bone loss and hormone imbalance
“There is a misconception that osteoporosis affects older women only, but bone loss is something we all need to consider from a young age and take the appropriate steps to prevent it,” says Dr. Rushdah Lariza Khan, a gynecologist practicing at Netcare Garden City Hospital.
Seven tips for protecting your bone health
- Get enough calcium – women should have 1,000 mg daily and increase to 1 200 mg from the age of 51; men should have 1000 mg daily.
- vitamin D – Our bodies need this important vitamin for bone strength, and supplements may be needed to achieve the recommended 600 international units (IU) of vitamin D per day, which increased to 800 IU from age 71.
- Protein – The building blocks of healthy bones require sufficient protein.
- Exercise – Do resistance training (for example weights, elastic bands, and water exercises) and weight-bearing exercises (such as walking, running, dancing, aerobics, or tennis) at least three times a week.
- Adjust lifestyle – Quit smoking and limit alcohol intake. Maintain a healthy weight.
- Appropriate use of hormone replacement therapies for women, at the correct age.
- Have your risk assessed, especially if you have other comorbidities.
Your hormone levels are critical to your osteoporosis risk
“The rate at which your body replaces bone tissue is influenced by hormones. Those with hormone-related disorders such as overactive thyroid or parathyroid glands, disorders of the pituitary gland, reduced estrogen or testosterone should discuss the implications for their bone health with a doctor and regularly screened for early signs of bone density loss,” Dr. Khan says.
“As a gynaecologist with the patients I see, the hormone changes that happen at menopause directly affect bone mineral density; however, women in their mid-twenties can start showing signs of deterioration. Athletes and women who miss their menstrual periods by six months or longer from excessive dieting or exercise may lose bone density,” Dr Khan explains.
“After menopause, the levels of the female hormone estrogen fall, leading to a rapid decrease in bone density. When women younger than 45 experience menopause or have a hysterectomy with removal of ovaries, this affects their estrogen levels and, therefore, their risk of developing osteoporosis,” she says.
Hormone replacement therapy may prevent bone loss
Hormone replacement therapy [HRT] is the most commonly prescribed treatment for managing the symptoms of menopause and the prevention of osteoporosis, depending on the woman’s health profile. Where other types of treatment are indicated, the patient is referred to a physician. ”It is so important for women to seek medical advice when they start menopause, especially if it is early menopause.”
Although there are both benefits and potential risks with any medication, gynecologists are specially trained to prescribe the correct HRT for the individual patient depending on their situation, while it is needed.
“HRT is safe when correctly prescribed by a specialist, with yearly follow ups, including an annual mammogram,” she advises.HRT in the form of patches, gels or sprays does not increase the risk of developing blood clots, although the tablet form can. Recent studies indicate HRT does not increase the risk of heart disease or stroke, provided the therapy starts within 10 years of the last menstrual cycle and before the age of 60.”
“Our bodies change as we get older, and women in their 60s should regularly discuss their need for HRT and review their treatment options with their gynecologist or treating doctors to manage potential risks, including osteoporosis, as appropriate for optimal healthy aging.”
There are other treatments available such as bioidentical hormone treatment or BHRT. This is what a US specialist says about BHRT.
BHRT explained
Dr. Leslie S. Gaskill, M.D. is a Primary Care Physician & Holistic Medicine Specialist located in Peachtree Corners, GA & Johns Creek, GA, in the USA. Dr. Gaskill often recommends BHRT because it’s safe and effective for most women. However, she also believes understanding the pros and cons of any treatment is important:
BHRT Pros
BHRT replenishes your body with either estrogen alone or estrogen and progesterone in combination to address the most common menopausal symptoms, such as hot flashes, vaginal discomfort, mood swings, weight gain, and insomnia.
BHRT can also help you prevent osteoporosis, bone loss, and reduced fractures, which are common in postmenopausal women.
Bioidentical hormones are most similar to natural hormones, so they may lead to better compatibility with your body and fewer side effects. Dr. Gaskill believes they can alleviate menopausal symptoms, improve mood and energy levels, and potentially decrease the risk of certain health issues like osteoporosis.
BHRT may reduce your risk of diabetes, cataracts, and tooth loss.
Your skin benefits from BHRT because the treatment increases hydration, thickens skin, boosts elasticity, and reduces wrinkles.
If you’ve undergone breast cancer treatment, studies show you can take BHRT safely, as it doesn’t increase your likelihood of breast cancer recurrence.
Now, for the BHRT cons
Despite their benefits, bioidentical hormones aren’t risk-free. In fact, they may have similar risks to conventional HRT, such as an increased likelihood of blood clots, stroke, and gallbladder disease.
You may also notice side effects when taking BHRT, such as:
- Bloating
- Fatigue
- Acne
- Mood swings
- Weight gain
- Increased facial hair
Although most women find relief from these symptoms with BHRT, some don’t respond positively. Dr. Gaskill can guide you toward other treatments if BHRT causes these symptoms.
Know the types and forms of BHRT
Like HRT, BHRT comes in several forms, including pills, patches, gels, creams, and injections. The best form depends on your health, the symptoms you’re trying to manage, and your lifestyle, so Dr. Gaskill discusses these factors with you to find the most suitable option.
Know who’s a good BHRT candidate
BHRT might benefit you if you’re experiencing menopausal symptoms that negatively affect your quality of life, but it’s not for everyone.
Women with a history of breast cancer, heart disease, liver disease, or those who are pregnant should avoid BHRT.
Hormone replacement therapy pros and cons
With HRT, you can relieve menopause symptoms with estrogen and/or progestin. Women can only take estrogen if they have had a hysterectomy, but if they still have their uterus, they need to take both estrogen and progestin.
There are two types of hormone therapy available – systemic and local. With systemic therapy, hormones are released into the bloodstream and go to the organs and tissues that need them, according to the American College of Obstetricians and Gynecologists (ACOG).
Local therapy is cream, ring, or suppository. It doesn’t get into the bloodstream and is for women suffering from vaginal dryness.
HRT can be beneficial, according to ACOG, by:
- Helping with vaginal dryness
- Protect against bone loss that can lead to hip and spine fractures
- Reducing the risk of colon cancer
- Relieving hot flashes, especially at night
There are also risks to HRT. Some risks include:
- Breast cancer (small but increased risk)
- Deep vein thrombosis (small but increased risk)
- Gallbladder (small but increased risk)
- Heart attack (small but increased risk)
- Stroke (small but increased risk)
- Uterine lining growth, which can increase the risk of uterine cancer
HRT is often recommended to be used to treat symptoms of menopause, but only on a limited basis. It’s recommended that women take time to weigh the risks and benefits and talk with their doctor about the best options for their individual health needs.
ACOG also recommends that women who do choose to use HRT use the lowest effective dose for the shortest possible amount of time.
We need hormones for healthy bones
Women are more at risk of experiencing bone loss than men because the hormone changes that happen during menopause directly affect bone density.
The female hormone estrogen is essential for healthy bones. After the menopause, estrogen levels fall. This can lead to a rapid decrease in bone density.
Be informed
The long-term implications of bone loss and osteoporosis are the increased risk of fractures from minor injuries. Immobility caused by these fractures can also have long-term consequences because it reduces physical ability, particularly in the elderly. Maintaining a healthy lifestyle and diet, undertaking regular exercise, and minimizing alcohol and smoking exposure are the most important steps to preventing osteoporosis.
Inform yourself! You must consider all of your options regarding hormone replacement therapy, including the pros and cons that may follow when using it. Speak to your trusted healthcare professional and always listen to your body.
References
Consider Pros And Cons Of Hormone Replacement Therapy | Premier Health
Source: J Scott Bembry MD, Ob/Gyn of Greene County, National Institutes of Health, American College of Obstetricians and Gynecologists
