Estrogen and osteoporosis

 

A woman picks up a bag of groceries and breaks her wrist. Another rolls over in bed and cracks her spine. A third falls and breaks a hip. These women have osteoporosis—brittle bone disease. Before menopause, estrogen protects bones. But after menopause, estrogen levels plummet, jeopardizing bone health.

 

What’s a woman to do?

By taking hormone replacement therapy (HRT) after menopause, women can stall bone loss.

 

But the protective effects of HRT last only as long as a woman takes it. That’s a problem, since many women discontinue or avoid HRT. Some dislike the idea of menstrual-like bleeding. Others fear uterine cancer (even though the addition of progesterone to estrogen therapy returns that risk to normal). And still others are afraid of a slight increase in breast cancer risk.

 

Overcoming worries

In spite of those valid concerns, many experts agree that, for most women, the benefits of HRT (it protects against heart disease, too) far outweigh the risks.

 

And for women taking HRT primarily for the bone benefits, here’s a new twist. Recent findings suggest that women who wait until after age 60 to begin long-term HRT may conserve nearly as much bone as those who start at menopause.

 

If you’re worried about your bone health, talk to your healthcare provider. He or she can assess your risk and help you decide whether HRT is right for you. He or she may also suggest one of the newer medications designed specifically for osteoporosis (see sidebar).