Premature Menopause and Bone Health

Estrogen May Not Be Enough to Prevent Osteoporosis. Are You Protected?

Bone density tests for osteoporosis. Mache Seibel

There is a lot to think about if you go into premature menopause. One in one hundred women enter menopause before age 40 – and that is the definition of the condition called premature menopause. And unless it is treated, having lower estrogen levels at such a young age can cause rapid bone loss that leads to osteoporosis or thinning of the bones. The question becomes, what is the best treatment and for how long?

That question was the subject of a study published in the September 2015 issue of the journal Menopause. The women in this study were a mean of 34.7 years. You can see how early menopause occurs in some women. These women were followed with a bone density test every two years for 8 years. None of the women had a hysterectomy (their uterus surgically removed) so they were all treated with a combination of estrogen plus a progestogen (either progesterone or its synthetic equivalent and in this study they were all treated with a synthetic progesterone) and the hormone therapy began on average 2.9 years after the women entered menopause.

After being on hormones for 4 years, 60% of the women had bone loss in their spines and 23.6% had bone loss in their hipbones. After 8 years of being on hormones, 50% had bone loss in their spines and 16.7% had bone loss in their hipbones.

In this study, by 2.9 years after they were diagnosed with premature menopause when the women began receiving estrogen plus progestogen, 46% of them already had lost some bone density or already had osteoporosis.

So what does this study mean to you and why am I sharing it with you? Here are 7 points for you to consider to better be protected if premature menopause happens to you.

  1. Menopause can come really early for some women and many of those women don't think menopause is possible at such an early age so they don't get tested for it.
  1. Waiting for 2.9 years to get diagnosed means there is almost a 50:50 chance you would already have bone loss before starting any form of treatment.
  2. Treatment with hormones alone may not be enough for at least half of women with premature menopause to prevent bone loss
  3. That means other forms of treatment might be needed to prevent bone loss in addition the estrogen and progestogen
  4. There are a number of medications on the market that could be used together with hormones to prevent bone loss. An example would be Fosamax.
  5. Another medication sometimes given to women with premature menopause to prevent bone loss in addition to estrogen and progestogen is testosterone.
  6. There is no evidence that taking estrogen therapy in premature menopause increases the risk of breast cancer to any greater than it is in women who menstruate normally.

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