Osteoporosis treatments

[Denise_uk]

I've recently had a DEXA scan and have been told that I already have a considerable degree of osteoporosis at 43 years old. Since my mid 30s various consultants have been trying to decide whether I was suffering from Polycystic Ovaries or premature menopause, and the latest round of tests, together with the results of the DEXA scan, would seem to indicate that it was premature menopause. I've now been referred back to my GP to discuss the alternatives for treatment, the two options basically being HRT of some kind to tackle the hormonal side and try to prevent further bone degeneration (the option favoured by the consultant) or bisphosphonate treatment to tackle the actual symptoms of the thinning bones directly. Does anyone have any experience of either of these treatments and can give me any information on their personal experience of them...benefits, side effects, effectiveness etc? One of my main concerns with HRT would be the associated potential for weight gain, as having managed to drop from 18 stone to ten and a half stone, I'm considerably less than keen to start any course of treatment that has a significant chance of being a ticket straight back up there!!!

I'm off to bed now (us old folks gotta get our rest! lol) but I'll check back tomorrow to see if anyone has been able to offer any opinions or advice.

Thanks in advance for your help,

Denise. x

[Ice.Maiden]

With being forced to go through a very early menopause Denise, I've refused to have HRT treatment - merely because of the higher risks associated with its use.

I don't know if I'm going to get osteoporosis - or WHAT to expect, really, so I'd also be interested to hear what other people say about this.

[Scarlett]

Hi Denise,
I can't offer any specific advice but I am interested in what your symptoms were. Did you get the normal hot flushes, or was it more to do with joint problems?
Amazing weight loss too- how did you do that!?x

[Denise_uk]

Hi Ice Maiden. Thanks for your post.

Yes, I'm with you on not wanting HRT, but I'm told that the risks associated with it are, in my case, outweighed by the probable consequences of allowing the osteoporosis to continue untreated. In your case you may never develop it - you're more likely to because of early menopause but it's by no means a foregone conclusion. If you have a family history of it (I do - my Mum had it) it increases your chances, as I'm told does yoyo dieting (guilty as charged again unfortunately), so I suppose given the evidence it was almost inevitable that I'd develop it sooner or later. My advice to you would be to have your calcium and vitamin D levels checked regularly, and take a supplement to be on the safe side, if you aren't already. If you're not having a DEXA scan every couple of years I'd also make enquiries about that. I think you can pay to have one done if your GP or consultant doesn't think it's justified on the NHS, and I don't think they're anywhere near as expensive as MRI scans. If you are unfortunate enough to develop it, the earlier it's picked up the better because the way I understand it once it's detected any existing thinning of the bones is basically irreversible, but treatment can slow down or halt any further deterioration.

Good luck, and all the best. x

[Denise_uk]

Hi Scarlett: Thank you for your post too.

To answer your question:
PART 1. In hindsight I think my symptoms started with irregular periods and difficulty conceiving about 15 years ago. It's hard to know what was going on before that because I was on the pill, which was regulating my periods. I managed to have my son, who is now almost 12, and after he was born my periods were still very irregular. I also started to develop some excess body hair which is a classic symptom of polycystic ovaries. At the time I was very overweight (18 stone), which is apparently common in cases of polycystic ovaries. My hormone levels were checked but the results were contradictory and inconclusive of being either polycystic ovaries or premature menopause for definite. At that time I wasn't getting any hot flushes, but my periods were becoming more infrequent. I was put on Dianette by my GP initially (a contraceptive pill proved to help with excess hair growth, which was my main concern) on the basis that without a lot of the classic symptoms of premature menopause at that stage it was more likely to be polycystic ovaries, especially given that I was barely in my mid thirties at the time. The Dianette helped to some extent, but not a great deal, so I was referred to the endocrinology unit at the hospital, where the consultant put me on a drug called Cyproterone as well as the Dianette, which did help to control the excess hair growth. By this time I'd also lost a considerable amount of weight, which I was told would probably also help if it was polycystic ovaries. I plodded along on my little concoction of medication quite happily for several years, having regular periods and no real symptoms of any sort any more, but when I saw my consultant for an annual check last year he said he wasn't happy leaving me on such high doses of hormones indefinitely now I was in my 40s because of the risks associated with it...

[Denise_uk]

PART 2. I came of the Cyproterone first and then the Dianette 6 months later, at which point the hot flushes kicked in and I had no periods whatsoever once the drugs weren't inducing them any more. At this point the consultant decided we really did need to find out for sure which one of the two illnesses I had, because the treatment from then on would be different depending on which it was. The tests earlier this year showed that it was almost certainly premature menopause because of my hormone levels, which had changed significantly since they were last checked. At that point I asked to be discharged and basically left alone to get on with it because I had no problem coping with the symptoms, and didn't like the idea of HRT one bit, but it was then that the significantly increased risk of osteoporosis was mentioned. I'd had no symptoms whatsoever to indicate that I might have it, so I agreed to have a DEXA scan on the assumption that when, not if, it came back showing I was fine, I could ask to be discharged and maybe just be scanned every couple of years as a precaution. That was plan A, which went out of the window when the DEXA scan results came back...

So, that's basically the story Scarlett. Sorry it's so long winded! lol. I'd still really appreciate any input from anyone who has experience of either HRT or bisphosphonate treatment. I have an appointment with my GP tomorrow afternoon to decide what I want to do, and I still don't know! lol.

Thanks,
Denise. x

[bigmamma]

I have osteoporosis and have had it for a number of years , mostly due to long term steroid treatment . I was given some course of 3 months drug to help calcium levels and prevent furthur damage .However I still have steroids on and off. I was thrown into the menopause in my 40s too and was put on HRT which I'm still on . x

[Denise_uk]

Hi bigmamma. Thanks for your answer, and sorry to hear about your health problems. Whats your opinion of HRT if you don't mind me asking? - did it suit you? I know everyone is different but are there any major pitfalls you experienced that it might be useful for me to be aware of?

Thanks again,

Denise x

[bigmamma]

Sorry to post so late but hoefully you wil see this tomorrow if you are in bed hun.
HRT seems to agree nicely with me and I have no problems , I did get given one first that gave me headaches so they changed it to a different one and I am fine with it . As for the weight gain you're thinking of , it has had no effect on my weight as I haven't gained at all .
I know not everyone wants to go onto it but I like it . xxx

[Denise_uk]

Sorry it's a bit late but just to say thanks bigmamma. I've been on Premique for about 2 weeks with no noticeable side effects (apart from a bit of bleeding which I was told might happen and was nothing to worry about) and, touch wood, no weight gain yet! lol. Early days yet but I'm keeping my fingers crossed...

I also fell down the stairs last week (seemed like a good idea at the time! lol) and my spine and hips still seem to be in one piece, so hopefully the bone thinning isn't too advanced yet either. Shan't be trying that again in a hurry though...!

Thanks again for the support and advice - much appreciated. x