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[trac896]

well I asked my doctor and she said no need, she won't refere me as feels like she can deal with me but I'm getting nowhere with her, I moved from Newcastle to North yorkshire (a small town) two years ago but was at menapause clinic, hospital ect before. Feel like I've nowhere to turn now. Feel very alone with it all xx

I know exactly how you feel.  I also feel alone, docs have got no idea on early menopause.  I went to a private meno clinic just recently but ime still not convinced I have the answers.  I find it interesting that you had osteopenia despite being on HRT.  Ime now questioning wether it's just your luck and some people will have brittle bones regardless of early menopause.

[Dana]

It's going to be a decision made by yourself and your doctor as to whether you should take HRT. However, my opinion is that you can't totally place ALL your faith in HRT to help with the osteopenia. It will probably go a long way towards helping your problem, but you are quite young to have started developing osteopenia, so I would be very mindful that you may also need to do other things to help prevent further bone loss.

My father had osteoporosis and broke his hip a few years before he died. My doctor has told me that when older people break hips they often don't survive much more than a couple of years. I was diagnosed with osteopenia probably in my late 40s, and I am now 55, so I am taking it very seriously because I don't want to end up like my father. His final years were miserable.

Menopause happened for me around the normal age of 50-51 and I have been on HRT now for about 3-4 years. When I had my last BMD test done about 6 months ago I was very disappointed to find that my osteopenia had gotten a little worse, despite being on HRT. I was hoping that at the very least it would be the same as it was 2 years prior. When I voiced my disappointment to my doctor she said that the HRT was helping, and that things probably would have been worse without it.

So her advice was that it was time for me to consider taking Fosamax once a week. I had been on it a couple of years ago, and it was definitely helping, but I was talked out of taking it by a naturopath I was seeing at the time. When my doctor recommended going back on to it I was reluctant, but I knew I couldn't allow the osteopenia to get any worse.

I'm a bit of a fan of Dr Elizabeth Vliet, so I checked her book to see what she said about Fosamax, and she was actually very positive about the benefits of taking it, so I decided to ignore all the interweb scaremongers and whacko naturopaths, and go back on to it. I only take it once a week and I won't know how it is working until I have my next BMD test next year, but I have hopes it will at least stop it from getting any worse, seeing as it did help when I was taking it before.

Just a tip – don't bother with the scans that a done on feet/ankles. They won't give a proper picture. Make sure your get a proper bone mineral density test done, which is a full body scan.

[CLKD]

Dana - we had to take what was on offer and the best place is the pelvis.  Not many HA's will do a full body scan unless they are looking for over-all problems ……. any scan is better than no scan at all.

Exericse is importa,t good impact walking.  My paternal grandma got a Doweger's hump despite being active all her Life ……. and eating well.  Everything was 'full' - cream, milk, cheese - no diluted stuff in her day so I don't know why it happened.  She never had fractures though so it was probably normal ageing.

[Dana]

A BMD is a scan of the neck/spine and hips/pelvis. I don't know how things work in other countries. However, in Australia, it is recommended that women over the age of 50 have full BMDs done every 2 years. They can be expensive (can't remember – maybe around $100-$200), and you do need a referral from your doctor, but medical insurance will reimburse a large proportion of the cost. Even if you don't have insurance, seeing as it's only every 2 years the cost is worth it IMO. I actually get mine done for free now though because I have had continued bone loss. If I had full osteoporosis I would also get them done for free.

All I'm really saying is that I personally don't think that anyone taking HRT should automatically assume that the HRT will protect them from bone loss, even if they are also taking calcium, Vit D, exercise etc - because I do all that too. Probably in my case I have a genetic predisposition to osteopenia/osteoporosis, but so may a lot of other people too. Bone loss is a very scary and serious thing. Don't make assumptions even if you are taking HRT. Get a proper scan done, even if you have to pay for it, because it's too late once it's gone. If everything is fine, then you probably won't have to worry about having another one done, but if it shows some issues it's best to be aware of them in the early stages and take action, as I have been able to do.

[Dancinggirl]

Dana - I agree with all that you say. Unfortunately bone scans are only done on the NHS here in the UK if there is a family history of bone density problems or you are at risk due to premature meno or you've broken a bone at our age. I had to really push to be given one last year.  I do think there is a strong genetic link as well and  lot depends on diet and exercise.  A friend of mine at the age of 55 slipped, fell and broke her sacrum - she had always been slim and active and appeared to have a very healthy diet.  Unfortunately her healthy diet of lots of fish, salads vegetables etc. did not include dairy - her skin also burned very easily so she always kept out of the sun. Her bone scan showed advanced stage osteoporosis!!!
I am far from complacent, I had a premature meno and though my mother has been lucky and not had a fall, she has lost at least 4 inches in height and I think a fall would be the end of her. I make sure I eat a bit of cheese and a fat free yogurt everyday and I do lots of brisk, power walking - I am also fortunate that my job involves lots of walking and climbing stairs.
I have had HRT on and off for many years and I'm back on it now (I'm 59)-  I dread to think what my bones would have been like by now if I hadn't.
Osteoporosis is serious and life limiting so I believe we should be doing scans and offering treatment for this far sooner in the UK.  DG x

[peegeetip]

Just to clarify on my question on which pill you were on.

Cilest 250microgram prog / 35microgram estrogen tablets.

If thats the same dosage as you've had then that not near whats required to protect your bones.

The lowest HRT tablet thats supposed to be used to prevent osteoporosous is 2mg estrogen or above. This is a much higher amount than you were on.

If you do decide to go to full HRT and ensure diet etc is working for you then your bones can recover.

Sorry about this but your doc should have put you on full HRT for early menopause.

Use the following link to see whats available.
http://www.menopausematters.co.uk/perimeno.php

CYCLO-PROGYNOVA 2mg has prog most similar to what you've been using or you could go with femoston or elleste as others say this is a good choice.

Hope that helps trac896

For Dana and Lila22 what HRT/dosages did they put you both on?
As mentioned diet has a part to play in our bone health too.
So many seem to go for low fat this and that and that can make it worse.

http://www.healthline.com/health-slideshow/build-strong-bones#1
This link covers some of the things I did not know about diet etc.
Quite astounded by the amount of milk we should drink to be "healthy"!

[trac896]

Just to clarify on my question on which pill you were on.

Cilest 250microgram prog / 35microgram estrogen tablets.

If thats the same dosage as you've had then that not near whats required to protect your bones.

The lowest HRT tablet thats supposed to be used to prevent osteoporosous is 2mg estrogen or above. This is a much higher amount than you were on.

If you do decide to go to full HRT and ensure diet etc is working for you then your bones can recover.

Sorry about this but your doc should have put you on full HRT for early menopause.

Use the following link to see whats available.
http://www.menopausematters.co.uk/perimeno.php

CYCLO-PROGYNOVA 2mg has prog most similar to what you've been using or you could go with femoston or elleste as others say this is a good choice.

Hope that helps trac896

For Dana and Lila22 what HRT/dosages did they put you both on?
As mentioned diet has a part to play in our bone health too.
So many seem to go for low fat this and that and that can make it worse.

http://www.healthline.com/health-slideshow/build-strong-bones#1
This link covers some of the things I did not know about diet etc.
Quite astounded by the amount of milk we should drink to be "healthy"!




Wow I am lost for words
All these years I thought I was on the pill because it had a higher level of estrogen.  This is what my GP told me.  She said I need to be on the pill not HRT because One I am too young to be on HRT and two I need a higher level of estrogen.
I feel so let down by the system.
That would probably explain why I have osteoenia and periodental disease ( loss of bone in the gums)

[peegeetip]

The pill did used to have high levels of estrogen but in recent years a lots of lower estrogen options have appeared that rely more on the prog part.

As mentioned there is also the diet aspect as I mentioned. Given that we're all so eager to "diet" and cut stuff out then it gives you a good reason to treat yourself to things that have plenty of calcium and vit d.

http://nof.org/calcium

Your bones are amazing and if you get onto a medium dose HRT and above and get your diet upto the recommended levels for calcium and vit d then you should be able to get there.

One without the other won't do all the work remember.

Your still not at osteoporosis stage, so take a positive view on that 
Just get the next step of the journey underway asap.

[Hurdity]

Hi there trac896

Further to peegeetip's post and your dismay at being let down by the system, just to add that you cannot compare the oestrogen dose of the type in Cilest, ie ethinyl estradiol to estradiol in HRT. The one in the pill (ethinyl estradiol) is much more potent than estradiol so a much lower dose is needed, so from what I've read (just quickly looking though!) the oestrogen dose is still higher than HRT. As far as I understand, it would not work as a contraceptive pill if it didn't have high levels of oestrogen. However this doesn't have a bearing on your condition but just needed to clarify.

If the recent research mentioned by lancashirelass at the Daisy network conference showing that oestrogen in the pill does not protect bones as well as HRT then you would have been given the pill in good faith that it would be protective - if you see what I mean.

I'm not sure if Qlara has been mentioned on this thread but this is a contraceptive pill with sufficient oestrogen (as estradiol) to be protective of bones, if you didn't want to take HRT.

Yes to the right diet and exercise 

Hurdity x

[trac896]

Thanks guys for all this really useful information.  I find it all very confusing but think I am slowly starting to digest it.
I contacted Nick  Panay for advice a short while ago and this was his explanation to me.

The pill contains a stronger synthetic estrogen (ethinylestradiol) but it may not be as good for bone mineralisation or metabolically.

This is why I have a preference for natural estrogen (estradiol) rather than ethinylestradiol in premature menopause.

However, more studies are required to confirm this.
Regards





I think that dog too much research gives you a headache and makes you very confused so I have come to the conclusion that if the pill hasn't protected my bones over the last 20years then what do I have to loose by going on HRT.  It is very similar risks and touch wood I have been ok up to now so HRT I think it is.
I just like to get my head round everything as I am so confused.
Thanks for all the great advice.  You have all been fantastic.  More info that I will ever get from my GP xxxxx

[CLKD]

We are a Mine of Information 

The Pill was designed for a totally different purpose.  HRT has come on in leaps and bounds as has knowledge …… sharing experiences, ideas, asking questions is the way to go! 

I think a GP should do a scan periodically otherwise  ……… one cannot know the state of the bone structure without ……….

[Dana]

Dana - I agree with all that you say. Unfortunately bone scans are only done on the NHS here in the UK if there is a family history of bone density problems or you are at risk due to premature meno or you've broken a bone at our age. I had to really push to be given one last year.  I do think there is a strong genetic link as well and  lot depends on diet and exercise.  A friend of mine at the age of 55 slipped, fell and broke her sacrum - she had always been slim and active and appeared to have a very healthy diet.  Unfortunately her healthy diet of lots of fish, salads vegetables etc. did not include dairy - her skin also burned very easily so she always kept out of the sun. Her bone scan showed advanced stage osteoporosis!!!
I am far from complacent, I had a premature meno and though my mother has been lucky and not had a fall, she has lost at least 4 inches in height and I think a fall would be the end of her. I make sure I eat a bit of cheese and a fat free yogurt everyday and I do lots of brisk, power walking - I am also fortunate that my job involves lots of walking and climbing stairs.
I have had HRT on and off for many years and I'm back on it now (I'm 59)-  I dread to think what my bones would have been like by now if I hadn't.
Osteoporosis is serious and life limiting so I believe we should be doing scans and offering treatment for this far sooner in the UK.  DG x

Yes I understand that the NHS may not allow for them, but neither does our Medicare in Australia if you don't have any prior history. I'm sure women would still have the option of paying privately for it though, as we have to here. I had my last one done for free because I have an ongoing problem, but prior to that I always had to pay for them. I just think that women owe it to themselves to get one done, even if they have to pay for it. If it is okay they may never have to do it again, but if it's not, at least they are aware of it.

All the things we are told to do may still not be enough. I eat a very good diet with lots of vegetables, protein, dairy etc. I also exercise at least 4 times a week and take Vit D and calcium. I'm on HRT, I don't smoke or drink, and while my weight is a little more than I'm happy with, I'm certainly not obese.

I'm just glad I had my first one done when I was in my late 40s because I became aware of a problem that I wouldn't have known about otherwise. There are no symptoms with bone loss, until maybe you break something. Also, considering my lifestyle, I would never have thought that I would be someone with a problem - but I am.

[peegeetip]

Hi Dana

what type of HRT are you on?

Sounds like your diet and exercise etc is good, which is great.

 

[Dana]

I'm currently taking 2mg estrogen with a separate medroxyprogesterone 10 days a month, which has been working very well, but I'm about to start trailing Norethisterone. Eventually I want to go to the continuous patches. I can't tolerate Utrogestan.