Osteoporosis and HRT
Many doctors now recommend that all women take HRT to protect their bones from osteoporosis. This is a condition in which the bones become brittle and break easily, causing distress and pain to some women as well as real danger by complications to elderly women. Osteoporosis occurs more readily in women because oestrogens inhibit the breakdown of bone. In fact they prevent bone making cells from being converted into bone destroying cells. This is still a controversial area of medicine, because there is insufficient research into the 50% of women who do not suffer loss of bone density, or into the mechanism by which men suffer (or don't suffer) osteoporosis and the evidence for HRT treatment of osteoporosis is still being gathered. There has been a huge rise in the number of osteoporotic bone fractures in women over 50 since the 1960s, so there must be other factors affecting women's health to account for this change.
Recent research has suggested that the number of times a woman ovulates in her lifetime affects the likelihood of her developing osteoporosis, so that prolonged use of the contraceptive pill, which suppresses ovulation may be linked with the onset of osteoporosis at or before menopause. Operations which remove the ovaries would have the same effect, as well as extreme physical exercise and eating disorders such as anorexia. These are all known factors which may contribute to the change in patterns of female bone health and more research is needed to establish their degree of importance.
Treatments for Osteoporosis
Biophosphonates are prescribed for osteoporosis. They work by sticking to bone and preventing it from breaking down. Brand names are:
- Didronel
- Fosamax
- Bonefos
- Skelid.
These are drugs which often cause severe irritation to the gullet, so great care has to be taken in managing them. They also interfere with mineral metabolism all over the body, so can have a lot of serious side-effects. They are saved for severe cases and, used with caution, can reverse osteoporosis Raloxifene is an oestrogen-derived compound which improves bone-density but increases clotting, so has to be taken with an anti-clotting agent.
