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Hormone Replacement Therapy Q&A

4. What can I do to protect against heart disease or osteoporosis? continued...

Without doubt, estrogen helps maintain bone health. But there are other alternatives you can consider:

Fosamax: Fosamax, Actonel, and similar bisphosphonate medications are designed to prevent or treat osteoporosis; they slow bone thinning and increase thickness of the bones of the spine and hip. This reduces the risk of broken bones. The drugs are so successful that researchers are now looking at administering the drug through once-a-year intravenous infusions so women don't have to take pills every day.

Evista: A new class of designer estrogens are also prescribed to prevent and treat osteoporosis. Evista, also known as raloxifene, was designed to selectively act on estrogen receptors on bone, but not on the uterus (where estrogen can increase the risk of cancer). Evista also helps treat and prevent breast cancer. Evista has another plus -- it has a favorable effect on cholesterol.

Calcium and vitamin D supplements: Older women and men should get about 1,500 mg a day of calcium. Dietary sources of calcium include fat-free milk, yogurt, and cheese. Also, eating more protein could help the body effectively absorb calcium and vitamin D, according to one recent study at Tufts University in Boston. Elderly people who took 500 mg supplements in addition to dietary calcium -- and ate about 80 grams of protein a day -- had better bone mass than those in the control group.

Exercise: Remember, 30 minutes of weight-bearing and strength-training exercise -- even for women in their 70s, 80s, 90s, and older -- can build bone. It's one of the most natural remedies, and one that will also help maintain a woman's overall health.

5. If I'm a woman approaching menopause, what should I do?

First, you may want to wait to see what menopause symptoms you experience and how severely they affect your life. Remember, some studies indicate that only 50% of women suffer significant menopause symptoms such as hot flashes, mood swings, or night sweats, and those symptoms usually last three to four years.

If menopause symptoms do cause you problems, talk with your doctor about lifestyle changes you can consider. Among them: A diet heavy in soy, regular exercise, cold beverages, limiting caffeine and alcohol, relaxation techniques such as yoga, and dressing light in natural fabrics.

If you're still uncomfortable, talk to your doctor about your individual risk from taking hormone replacement therapy for a limited period of time. Remember, each woman's risk is different, based on her family history of cancer and heart disease.

Lastly, in light of the latest research, re-evaluate your need for hormone replacement therapy once a year with your doctor. The menopause symptoms that bother you may ease or disappear before your menopause officially ends.



WebMD Medical Reference

Reviewed by Mikio A. Nihira, MD on August 14, 2012

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