To make a significant impact on the risk of osteoporosis, you will require HRT for at least ten years, ideally starting therapy within about two years of the last menstrual period. It does appear that the longer a woman remains on HRT, the stronger her bones. Another factor to consider, if you are a smoker taking oestrogen to avoid osteoporosis, is the importance of quitting because smoking reduces oestrogen’s protective effect on bone.

Various studies show a 50 to 75 per cent reduction in the risk of fracture from osteoporosis after extended HRT. An adequate hormone dose is vital. The minimum daily oral dose of oestrogen required for prevention of bone loss is 0.625 mg of Premarin, 1.25 to 2.5 mg of Ogen, 2 to 4 mg of Progy-nova, or 0.02 mg of Estigyn. Some women prescribed HRT primarily for symptom control have more than an adequate dose to maintain their bone strength. In other cases, the prescribed dose is insufficient to prevent bone loss: some women have a low tolerance of hormones and are on the minimum, others smoke or have dietary imbalances that interfere with oestrogen uptake, and others again have such a fast rate of bone loss that even maximum hormone doses cannot keep pace.

For example, Premarin protects bones in most women at a dose of 0.625 mg daily, but studies tracking women’s bone density over a number of years indicate that 15 per cent need twice this amount to gain protection. Yet other studies show that half this amount, as little as 0.3 mg of Premarin a day, is effective if combined with a daily intake of 1500 mg of calcium. Women whose menopause occurred many years previously may need to start at a lower hormone dose to minimise possible unwanted effects like breast tenderness. Dosage levels may then be increased gradually if prevention of bone weakness is a major reason for taking HRT.

Oestrogens can be used in pill, implant or skin patch form. If you still have your uterus you will need to take a progestogen as well to protect its lining from an increased risk of cancer. The chances of this cancer developing are about one in 25 000 for women before menopause, and one in 1100 for women not on oestrogen after menopause or women with a uterus receiving both oestrogen and progestogen. The risk of endometrial cancer for women with a uterus who use oestrogen alone in pill, patch or implant form for five years or more after menopause increases to approximately one in 200. However, with an adequate dose and duration of progestogen, the risk falls again to one in 1100 or less.

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Related Posts:

• INTERMEDIATE SYMPTOMS OF THE MENOPAUSE
• HRT QUESTION: WHEN SHOULD PREVENTION OF OSTEOPOROSIS START?
• HOW TO IMPROVE SEX DURING AND AFTER MENOAUSE: HORMONE THERAPY
• HRT: WHAT ARE PROGESTERONE AND PROGESTOGEN?