Conventional Hormone Replacement and Osteoporosis | WHAT TO DO IN 2023
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- Опубликовано: 2 июн 2024
- Conventional Hormone Replacement In this video, Dr. Doug Lucas delves into the realm of conventional hormone replacement therapies as a strategy for managing osteoporosis. Watch this video to learn more on improving your bone health and lifespan.
Watch and Enjoy! Dr. Doug Lucas Key Moments in this Episode
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00:00 Intro and summary
1:20 Study 1 & 2
7:14 Birth Control
11:20 Masterclass Registration Link
11:35 Free E-book Link
12:00 How does this relate to bone health?
18:18 Healthspan Nation Link
Study 1 Link: pubmed.ncbi.nlm.nih.gov/12117...
Study 2 Link: pubmed.ncbi.nlm.nih.gov/12117...
Study 3 Link: pubmed.ncbi.nlm.nih.gov/16026...
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SIGN UP FOR MY FREE MASTERCLASS USING THE LINK BELOW!
Click here: www.optimalhumanhealth.com/bu...
Masterclass details: Hosted by Doug Lucas, DO, Board Certified Orthopedic Surgeon and Anti-Aging Specialist, you'll gain insight into the lifestyle, nutrition, testing, and medical solutions for Osteoporosis management and yes, possibly, even reversal.
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This channel is focused on Bones, Hormones, and Healthspan to help midlife women and beyond aim for optimal, not average, and reignite their spark!
The videos on this channel will be focused around helping women navigate healthspan and longevity through the lens of osteoporosis, perimenopause, and menopause. When it comes to osteoporosis and menopause providers and educators often get tunnel vision and your symptoms might get better, but if you don't keep longevity in mind, symptom improvement may come at the expense of heart and brain health.
Subscribe and follow along as Dr. Doug Lucas explores the research and clinical applications surrounding women's health.
ABOUT DR. DOUG LUCAS
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Dr. Doug Lucas: Owner/founder of Optimal Bone Health and Optimal Human Health. My team and I work together to create custom bone optimization plans for individuals based around supplements, hormone optimization, peptides and more in order to increase bone health and longevity!
Optimal Bone Health www.optimalhumanhealth.com/
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#osteoporosis
#hormones
#bones
![Darren Waller - Who Knew (Her Perspective) [Official Video]](http://i.ytimg.com/vi/GytDjB8u6bM/mqdefault.jpg)
I was on injectable Depo Provera for 23 years for contraception. Finally discontinued in my late 40’s and hit menopause at 49. Osteoporosis diagnosis at 50 (3 years ago) after twisting my PCP’s arm for a Dexa scan. I was suspicious that Depo Provera caused the OP but the Doctor’s just look right through me when I ask about it. Glad to have a little validation here.
I have implemented many of your recommendations for bone health and I’m dialing things in while fighting off the Bisphosphonate pushers. None of my provider’s including Rheumatologist have taken a well rounded approach. Not one of them talk about nutrition or exercise.
I appreciate your videos so much.
Thank you for sharing this. I am glad these videos are helpful!
In 1999 I was 44 years old and had a hysterectomy that also removed my ovaries. I started Premarin 2.5 and luckily always found a doctor that wrote a prescription for me although it got difficult and I talked hard to get it. I’m 80, now on estradiol .1 and am osteopenia. I look 70 and have no health issues.
Thank you for sharing this!
I mistyped 1989. I stand corrected. I had a hysterectomy at 46 is my point that also removed my ovaries and in those days before the premarine scare my doctor started me on 2.5. I believe estrogen kept me from having osteoporosis at a young age. I am required to get a mammogram every year. My genetics are for osteoporosis. I am fortunate to only be osteopenia at 80 3 months from 81. Very active healthy and grateful to caring doctors who listened to me.
Thank you 🤗
Still such a battle for so many women to get HRT, and at the optimal doses. The WHI study has been misused against women for years. I'm very fortunate to be on it in my 50s, E, micronized P, and T, and wish I could have started 5 years earlier. I dearly wish my mother could have been helped by it. She suffered badly. She was on HRT in her late 40s, then it was stopped due to the WHI panic, she developed osteoporosis. She was a coeliac, like me. I'm very optimistic that HRT will be even better in the near future, as long as we women are actually being offered it 😊xx
Thank you for sharing this!
Same. Finally on it, but wish I had started a few years ago. My doc is still stuck on the WHI and doesn't have the current science. I've had to push hard to get what I need. So simple really but what a shit-show this is for us Gen Xer's trying to feel better and having docs that are deaf, dumb and blind to menopausal symptoms and the diseases we get without HRT.
@@GiGi-fd6om well done, I'm very glad you have your HRT 🤗xx
@@GiGi-fd6om I just did a live talk on that exact topic. The endocrine society says there's no identifiable syndrome of testosterone deficiency in women yet many of the symptoms of menopause that aren't improved with estrogen are identified in men as symptoms of aging and hormone loss. In women they are just....... It's a shame. In women loss of libido is a psychiatric disorder. In men it's a medical problem treated with sex hormones. WTF.
@@Dr_DougLucas Compounding pharmacist told me there are no studies because hormones cannot be patented.
Am going to watch again as I am still confused about projestins. My doctor is balking about me taking HRT but not about biphosphonates--don't get that.
Thanks for your always informative, enlightening videos! I recommend you to other confused women with osteop... , with great regularity.
Thank you for watching!
I started HRT in 2018 at age 50 after two parathyroid tumors and then menopause when I lost a lot of bone. Started off w .075 estradiol patch/oral progesterone. Went to oral Premarin/progesterone and now back to estradiol patch at .025 strength/200mg micronized progesterone, Having my blood levels checked to see if Im getting enough to cover bone loss. I have halted my bone loss these last 5 years with no side effects. Last week at my GYN I mentioned I looked into Bioidentical Hormones and she mentioned they have been seeing women coming in with endometrial cancers who were doing BHRT👀
Thank you for sharing this!
I took BHRT for 5 years and that was 15 years ago. No problems. It is however difficult to find a physician well versed on this topic and with the ability to prescribe it competently. Apparently your GYN is drawing a correlation between BHRT and the incidence of uterine cancers. You may want to ask her to site the article and research she is referencing. If she can’t you may want to try a different MD.
Thank so much, as always!
Thank you for watching!
Great video, Dr. Doug!
Glad you liked it!
Fantastic clarity and explanation thank you Dr Doug.
Glad it was helpful!
Just came across your channel. So glad I did!!
Thank you for your support!
Thanks so much. Always get much value from your content .
At 52 I decided on HRT as part of my health plan following BMD diagnosis. I was made aware of risk factors and made an educated choice. It has had other benefits including mood balance and a cessation of incredibly uncomfortable dry eye syndrome which is a real relief as I was reliant on eye drops previously. I am grateful that you mentioned young women and I am very aware of my own daughters health moving forward.Thanks
Thank you for sharing this!
Another excellent and informative video! My endocronologist has me on birth control due to having osteoporosis, and I am hoping to get off of it. Thank you 😊
Best of luck! Thank you for sharing this.
Would be great to hear your thoughts on men, osteoporosis and testosterone 🤞🏻many thanks for your excellent information to date 🖖🏼
Thank you for the feedback, I appreciate your support!
Very interesting as always. If I might make a few suggestions for future topics - effect of estrogen on bone health in men - any associations between arthritis and osteoporosis - association of bodyweight on osteoporosis?
Thank you for your feedback and recommendations!
My mother had breast cancer that wasn’t estrogen sensitive. I had a very late pregnancy at age 47. I weaned my child at 13 months and opted for natural menopause since my mother had DCIS. She was an X-ray technician for 50 years. Perhaps her risk was influenced by her exposure. Later in her career she was wearing lead aprons but early in her career the badge monitoring wasn’t done. So I have allowed myself to go into menopause with no hormone replacement. I had to weigh the risk versus benefits.
Thank you for sharing this!
6:48
Thank you, Dr Doug. Over the course of educating myself about menopause and bone loss via evidence based sources, I heard that there are progesterone receptors on our bones. I’d like to learn more about this, in terms of the reasons for this and the specific function (natural) progesterone plays for female bones. Have you come across this information by any chance? I’d love to learn about it.
Hi there! Yes, there are progesterone receptors on bones and progesterone plays a role in upregulating osteoblast function and proliferation. The impact is that elevation in Progesterone will balance the cyclic increase in estrogen while a woman still cycles. In menopause we can use the same pathway to encourage osteoblasts but I've not seen it studied independent of estrogen to see what the impact alone would be.
@@Dr_DougLucas Thank you very much for your reply, Dr Doug! I appreciate it. 😊
Thank you for your continued support!@@cm1906
Thank you for this topic. Would you consider treatment of estrogen patch with progesterone and testosterone for a 53 year old woman with osteoporosis, taking tamoxifen for 5 years (finish in April) for prevention of breast cancer due to Lobular Carcinoma in situ? Or is that an absolute No-No?
According to my oncologist I can Never take HRT because my breast cancer was ER+98% & PR+ 85%, 1-2-19 STAGE2B IDC...Unfortunately now after being on Anastrozole 2.5 yrs since June 2021 after 2.5 yrs of Tamoxifen my Bone Scan went from Above Normal Bone Density November 2021 to Osteopenia in both Left & Right femoral neck!
Now she wants me on Osteoporosis medication and I said NO!
She also wants me to continue Anastrozole for a total of 5 yrs through June 2026 and I am Really Reluctant to continue after finding out how much bone loss I've had since November 2021!!! 😢 Beverly
Thank you both for sharing. These are common and challenging situations. It's difficult to make blanket recommendations when cancer treatments are variable and recommendations differ from oncologist to oncologist. My approach is to consider and work with the oncology treatment and mitigate bone loss as best we can. Sometimes that means pharmaceuticals for a brief period of time. Remember that long treatment of antiresorptives may not make sense but a shorter course while exposed to an aromatase inhibitor may make more sense. It's a tough decision that we walk patients through. I wish you both the best on your journey.
Have you done any videos about the study on MBP for improving bone health?
yes, search dr Doug Lucas proven supplement for reversal of osteoporosis.
Love your show Dr. Lucas but please consider lowering the volume of the music. Every time it plays I have to scramble to turn down the volume for just that part of the episode.
I appreciate your feedback!
Same comment as before: you need 2 channels, 1 for women, 1 for men.
And I wish you'd say something about calcitonin injections. At some point in time calcitonin has been taken off the market (except for Paget's disease or similar), probably under huge pressure from pharmaceutical competitors who want to push bisphosphonates, and based on almost zero evidence that it increases cancer risk.
What we do know for certain is that bisphosphonates are the nasty stuff that caused "phossy jaw" in match factories until the early 20th century. Let's learn from that.
Thank you for this feedback!
Didn’t they say calcitonin caused cancer? Prob was bs to make room for the drugs. Would be interesting to know
I have watched a previous video where you I thought you basically said don't use progestin. You made reference at end of this video? So you have changed your mind? And just curious if you took down the other video.
No, I don’t like them and I haven’t taken down any videos that I’m aware of. I believe what you are referring to is my comment about the fact that combined therapy with estrogen and progestins still showed benefit from a bone health prospective in the WHI. If it’s all someone has access to it’s better than none. I would prefer no progestin but not everyone has the choice to choose.
Thank you but what dose do you recommend? And what is the blood levels that help bone growth?
Our dosing is variable and depends on the patient. We also use biomarkers to verify adequate blood levels. We aim for a minimum of 40 pg/ml of estradiol in serum.
I always find it helpful to turn on closed captioning when I’m trying to learn from videos…
Thank you for your feedback!
I am on the pellet with progesterone pill what do you think about this way of hormones? It helps me with sleep and aches. They said it was natural. Please help with some info.
Hi there. You can get bioidentical HRT through pellets but I don’t like the dosing and swing up and down you get with pellets. Oral micronized progesterone is what we use.
I wish I was prescribed estrogen after my early menopause.15 yrs later with steady ppi meds gave me early osteoporosis.Any idea my questions?
Lots of ideas but I can't give specific recommendations to patients on this platform. Consider joining our free masterclass, bone foundations course of HealthSpan Nation for more information and resources.
Can you share if any of this is different or has stayed the same with the new 2022 standards from the women's health initiative.
Recent publications have not changed the data presented here.
What amount of estrodial cream and oral progesterone and topical testosterone? I am 62 and diagnosed with osteo. And have a bad osteo hip
This will vary per person and we use biomarkers to dial in the dose. It must be done carefully to limit risk and side effects.
Can you use HRTs while on anti-resorpative or anabolic OP drugs?
Yes, they are not conflicting in mechanism. The question is do you need drugs if on HRT?
Are my kids safe ? I took progesterone suppositories & 2xs a month shots to help me carry my children.After I was told to stop all progesterone 2 weeks later my baby's were born early.So are my kids safe now because of in utero exposure?
I'm not an OBGYN so I can't comment on the in utero risk associated with progestin or progesterone exposure.
I’ve been reading that turmeric curcumin is good for restoring bone loss. Is that true?
Wouldn't think alone it would do much. Haven't seen a study with it as the independent intervention.
What about Bioidentical hormone creams? estradial and progesterone
We use and recommend Estradiol cream, oral progesterone and topical testosterone cream as well.
I had estrogen positive breast cancer. No hormones for me.
Thank you for sharing!
There is a clinical trial going on that is using testosterone with an aromatase inhibitor on breast cancer patients. So far, the results are good. The inhibitor prevents testosterone from turning into estrogen. But the benefits from a female dose of T protect bones, increase libido, mood and focus as well as muscle increase.
@@GiGi-fd6om Can you give more information about this article? The title or something I can search?
@@GiGi-fd6om That's an awesome trial and idea! Can you link me to the trial info?
I was on the estriol patch for a long time and in the past my insurance company said they wouldn't cover it any more because it is dangerous for a woman my age which is 70. I am also on oral progesterone. What should I do?
I have always paid out of pocket for compounded HRT. My dr sends over a prescription. I’m 78
There are some commercial preparations of estradiol and oral progesterone however insurance coverage is always spotty. They'll use whatever they can to not pay for prescriptions and services.
@ritadennis5752 me too.. I'm 82 , it changed my life at menopause. I use bio identical hrt which I pay for myself.
For me..on bc pills in my youth. Estradiol with and without Progesterone....i am 66 now and feel let dont...i fractictured..l4 lower back ans dispite hormone therpy..still developwd osteoporisis....i should add though that all women need to be screened for parathyeoid issues....i was not aware and do not think a lot of wonen are
Thank you for sharing this!
Is it possible to gain excellent metobolic health and that way protect your post menapausal bone health without supplemental hormones?
It's possible to optimize lots of things without HRT but they are powerful tools to consider.
What conditions would make one a candidate for HRT?
Not having naturally occurring sex hormones. Period. Better question is what condition makes someone NOT a candidate for HRT.
One more comment. The dose of estrogen in the pill is higher than the dose of estrogen in menopause hormone treatment. The pill uses ethinyl estradiol (ee), usually 20 micrograms (mcg) per pill per day. Menopausal women often use Beta-estradiol and the doses are different. 5 mcg of ee equals 1 milligram (mg) of oral estradiol (e2) equals a patch of 0.05 mg daily, a common dose. 1,000 mcg equals 1 mg, so oral ee is 200 times stronger than oral e2 (200 times 5 equals 1,000). The pill with 20 mcg of ee has 4 times the amount of estrogen as menopause e2. Sorry for the numbers but this is important. The pill using 20 mcg of ee has 4 times the amount of estrogen contained in typical menopause hormone therapy. The pill is just as good if not better than hormone therapy at preserving bone density. We do not use the pill after menopause because the dose is higher than what is needed. But there is NO concern for bone loss on the typical combined pill.
Thank you for sharing this information!
I'm 61, and my doctor told me it's too late to go on HRT. Is that true? I've heard it can also help stave off senility in older women too.
No, it’s not too late but lots of GP’s are not up to date with the latest information (or interested). I started HRT at 67 and in the face bk group I joined,
Osteoporosis UK -friendly support and natural options, there are ladies in their 70’s and even at least one in her 80’s that started it.
A Wiley Protocol doctor explained to me that it’s not safe to start estrogen later because if you are menopausal and have not been on it, you’ve developed cholesterol in your arteries. If you now start taking estrogen, the cholesterol will break free and can cause heart attacks and strokes.
I'd like to know the answer to this also. I am 62 and my doctor just started me on HRT (compound cream) therapy.
Great thread and topic! This is a challenging question because there does appear to be risk in starting hormones >10 years after menopause. So, what do we do? We evaluate cardiovascular risk with history, biomarkers and imaging to get a sense of disease in the arteries. For those that have very little disease it's reassuring and we will consider starting. For those with moderate to severe disease we consider alternatives like progesterone, testosterone and Raloxifene alone which each have an impact on bone health.
What are your views on OsteoStrong?
Checkout the video on my channel called "Maybe the Best Alternative Exercise for Osteoporosis That You Can Do At Home?"
The links don’t work. Out of date?
Hi! Sorry about that, the links should work. You can find the masterclass details here --> www.optimalbonehealth.com/build-bone
Our E-book is included in our Bone Foundations Course here --> www.optimalbonehealth.com/bonus
You can also find it on amazon!
They don't call it hormone "replacement" therapy any more, because it's not replacing something that would be expected to be in an older woman anyway. They just call it hormone therapy.
Thank you for sharing this!