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Hormone replacement theraphy: avoiding osteoporosis HORMONE REPLACEMENT THERAPHY: AVOIDING OSTEOPOROSIS
‘Osteoporosis and its consequences may be regarded as one of the most serious long-term consequences of the human menopause.’ from Focus - The Menopause, International Monograph Series, 1990.
‘We are all aware of the undoubted benefits of HRT in preventing bone loss.’ letter in British Medical Journal, 1990.
It is possible that you have read this far through the book without having a very clear idea of what osteoporosis is. You probably know that it is something to do with bones, and from your reading of previous chapters that hormone replacement therapy seems to help prevent it. But what exactly is it? How serious is it? How likely are you to get it? And what can you do to prevent or treat it?
What happens when you stop taking HRT?
When you are no longer taking oestrogen, the osteoclasts start dissolving bone away faster than the osteoblasts can replace it, and calcium in your diet is used less effectively. Therefore, you will start to lose bone again at about the same rate you would have lost it if you were not taking HRT. However, even five years on HRT will 'buy' you five years' delay in developing osteoporosis, which may make all the difference to getting a fractured hip or a bent spine. In an older person, this difference between getting or not getting a fracture can mean the difference between life and death.
What effect does progestogen have on osteoporosis? One advantage of progestogen is that it does not appear to counteract the beneficial effects of oestrogen in building bone. It may even give some increase in bone density. So if you are unable to take oestrogen because of a medical condition, and you are worried about osteoporosis, progestogen on its own may help you.
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