Maintain Bone Density After Stopping Hormone Therapy

Menopause and Bone Density

By quitting combination hormone therapy, post-menopausal women avoid the drug's risk for breast cancer, heart attack, stroke and dementia.

However, since estrogen increases bone mass, women also increase their risk for osteoporosis when they stop taking the combination of estrogen and progestin.

"Fortunately, it is not necessarily the end of the line if you cannot take estrogen," said Dr. Ronald Young, an associate professor of obstetrics and gynecology at Baylor College of Medicine and a co-investigator of the Baylor Clinical Center of the Women's Health Initiative. "There are many options for women to maintain their bone density."

Many medical experts advise taking combination hormone therapy only for short-term relief of the symptoms of menopause, based on the results of the Women's Health Initiative study, which found health risks associated with the use of estrogen and progestin.

Short-term estrogen use, however, does not offer the body's bones enough protection. Drugs designed specifically to protect bone density, such as bisphosphonates, in addition to a healthy diet rich in calcium, vitamin D and vitamin K and weight-bearing exercise, can help fill in the gap.

Doctors recommend the following tips to prevent bone loss:

Eat right: Consume foods that are high in calcium including dairy products like milk and cheese. Leafy green vegetables also help build strong bones.

Exercise: Weight-bearing activities strengthen bone and can include anything that forces the body to work against gravity. Examples include walking, jogging, stair climbing, even dancing and weight lifting, either by using free weights or an exercise machine.

"Walking and just moving your body more are primary ways to strengthen bones," said Dr. Jennifer Hays, director of the Center for Women's Health at Baylor and principal investigator of the Baylor Clinical Center of the Women's Health Initiative. "If you don't have a set of weights you can use things around the house, like a can from your pantry, and do some curls. A weight training program doesn't have to be expensive or difficult."

Know your risk: Caucasian and Asian women, women with small bone structures and women with a family history of osteoporosis are most at risk for osteoporosis. But all women approaching menopause will lose bone density. One in two women will have an osteoporosis-related fracture in their lifetime, according to the National Osteoporosis Foundation.

Get scanned: A bone scan is an accurate way to determine a woman's bone density and is offered by gynecologists, internists, primary care physicians and gerontologists. Women with risk factors for osteoporosis, which includes getting off hormone therapy, should start getting bone scans after age 50.

08/12/2003