|
|
Post by jacksfullofaces on Aug 27, 2012 10:40:39 GMT
When estradiol ceases to circulate - osteoporosis is a very real risk to female health. It is said that one in three beds occupied in an NHS hospital are used by those women suffering from a health condition triggered by menopause.
Osteoporosis is silent. Often the victim is unaware that she has it until she experiences a fracture. DEXA scans are not routinely performed on the NHS to screen for this condition.
Women at risk of this disease include those with a small bone structure,family history, women who suffered eating disorders, women using steroids long term and those women using aromatase inhibitors. Often osteoporosis is treated with calcium supplements. They are not metabolised in the same manner as calcium eaten normally and frequently the supplement causes indigestion. Interestingly women from the Gambia do not suffer the disease despite eating a diet low in calcium. But the European Directive orders calcium and bisphophonates and praises the UK for being compliant with osteoporosis guidelines.
Another problem caused by bone density is the threat to dental health caused by jaw shrinkage. Often the teeth become loosened and are lost.
Bisphophonates are a difficult family of drugs to tolerate as they can splash the oesophagus causing burns as a result the woman has to remain standing for half an hour after taking the drug. Injectables are available but strictly rationed by the NHS.
Side effects include gastric irritation and jaw necrosis.
Until the big scare stories - HRT was considered the gold standard treatment to prevent this killer disease but now there are pieces of bland advice about diet and exercise.
|
|
|
|
Post by jacksfullofaces on Aug 27, 2012 12:05:14 GMT
|
|
|
|
Post by jacksfullofaces on Aug 27, 2012 12:08:06 GMT
Other facts women very likely to end up in care homes due to menopause causing osteoporosis. This is no better then the ancient Chiese custom of binding womens feet.Older women are now imprisoned by Zimmer frames.
Jacks
|
|
susan
Member
I refuse to join any club that would have me as a member - Groucho Marx
Posts: 749
|
Post by susan on Aug 27, 2012 15:12:11 GMT
I now know that I had a dreadful peri-menopause and through ignorance didn't really know what it was. From age 42/43 onwards I felt like I was falling apart, I had many GP appointments, a few Consutant referral, physio, CBT, my main physical symptoms was severe aches and pains.
After three or four years (and a huge struggle to get the former recognised) I was officially diagnosed as having Fibromyalgia and Osteo Arthritis.
Nobody mentioned I might be in peri-menopause during what was numerous medical appointments.
My mood swings and anxiety were off the scale.
Nobody mentioned the hormone connection.
Ironically I now realise this was all happening around the time of the WHO and WHI reports so they were probably terrified to mention hormones incase I had the nouse to ask for HRT.
I feel a fool having lived through a peri from hell and not even realising what it was.
I can still be a grumpy old witch at times, sometimes i think it's in the genes rather than the hormones in my case.
xxxx
|
|
|
|
Post by jacksfullofaces on Aug 27, 2012 15:19:19 GMT
|
|
|
|
Post by jacksfullofaces on Aug 27, 2012 15:32:48 GMT
jacks - thanks for the link I am not clear however why this is an EU directive preventing use of oestrogens in preventing osteoporosis or have I got the wrong end of the stick of what you are saying? It looks like guidelines on designing studies to test the effectiveness of new products being brought out to treat osteoporosis, and it says this includes hormone replacement therapies. Maybe you could help clarify this for me please as it is v interesting topic and I am learning quite a lot of new stuff here? Thanks Bellaciao x Bellaciao I should have senrt the booklet.The only references I have found for hormones are the SERMS which are very different to estradiol. Jacks |
|
|
|
Post by Gelis on Aug 27, 2012 18:23:55 GMT
Osteoporosis is my big worry. As my gynae wouldn't let me have HRT, I've just done the best I can diet wise.
As I've said elsewhere, I'm looking for another gynae, so may be able to renew my acquaintance with HRT in the future, but will continue to ensure that I keep the calcium in my diet as high as I can.
One of my aunts has severe osteoporosis. She takes calcium and bisophonophates - and now has a good GP who monitors her regularly. However, she used to be the same height as me - 5'6", and is now 4'10"! She's 87, and has been suffering with this for about 25 years, since a workplace injury which damaged her spine and forced her to retire early. She had a hysterectomy in her 40s, and was never offered HRT.
Gxx
|
|
susan
Member
I refuse to join any club that would have me as a member - Groucho Marx
Posts: 749
|
Post by susan on Aug 29, 2012 10:05:47 GMT
This is one of my big worries Gelis. Like your Aunt my Mother had osteoporosis, she was 5ft 4in and at the end was 4ft 11in. So she was not particularly tall in the first instance and lost 5 inches in height.  She suffered at least three fractures during her late 70ties. For the last five years of her life she had what in slang I believe is called a 'dowagers hump' which is to a certain extent disabling and of course unsightly and she was embarrassed by it. She was never offered HRT even though HRT was around when she was going through menopause. From an early age all the signs were there (as mentioned by Jacks) she lost all her natural teeth by age 40, not because there was anything wrong with her teeth, but due to bone erosion in the jaw. Until the scare stories HRT was the 'Gold Standard' for stopping all this, my gut feeling is it is far more effective than just diet change (if it was only that simple) and by the time people are filling themselves with calcium supplements it's often too late as the damage is done. I can see good arguments for something like Menostar which is a 17 mcg (?) patch with a couple of 6 monthly doses of progesterone for those with a womb. Or even half a 25 mcg patch if Menostar is unavailable in any given Country. But the medical profession no longer seem interested in the fate of menopausal women to the extent they wish to prevent all this. They seem to want to wait until it all goes pear shaped and then treat us. xxxx |
|
|
|
Post by jacksfullofaces on Aug 29, 2012 10:10:56 GMT
Susan
It might not be profitable to wait for things to go wrong but doctors get an awful lot of patients paying their salaries when it does.
Jacks
|
|
|
|
Post by jacksfullofaces on Aug 29, 2012 10:18:15 GMT
Oral bisphosphonates are cheap and are
recommended as first-line treatment by the
National Institute for Health and Clinical
Excellence (NICE) and other guidelines.4 The
high cost of teriparetide restricts its use to those at
very high risk, particularly of vertebral fracture.37
Other approved interventions for
postmenopausal women include calcitonin,
calcitriol and etidronate. Denosumab, a RANK
Ligand inhibitor that reduces osteoclast activity,
has recently been approved and NICE has
published its final appraisal determination (FAD)
recommending denosumab as a treatment option
in patients unsuitable for oral bisphosphonates.38,39
Hormone replacement treatment (HRT) is no
longer a first-line treatment for osteoporosis.5
A problem
|
|
susan
Member
I refuse to join any club that would have me as a member - Groucho Marx
Posts: 749
|
Post by susan on Aug 29, 2012 10:40:26 GMT
Susan It might not be profitable to wait for things to go wrong but doctors get an awful lot of patients paying their salaries when it does. Jacks There is definatly a 'lack of joined up thinking' going on somewhere as is usual in many very large organisations. I'm sure in the long term if womens health during menopause was looked after to a suffcient extent (not just sticking everyone on AD's and Statins) there could be monetary savings long term. xxxx |
|
|
|
Post by jacksfullofaces on Aug 29, 2012 15:31:38 GMT
It says "may be considered" this is the osteoporisis charity not the BMS whose advice I just posted
Jacks
|
|
|
|
Post by jacksfullofaces on Aug 29, 2012 15:35:29 GMT
I concede I have strong views and may end up in a padded cell. However I will not end up wearing hip padding because I'm sticking to a high level of hormones to prevent osteoporosis  Jacks xxx |
|
susan
Member
I refuse to join any club that would have me as a member - Groucho Marx
Posts: 749
|
Post by susan on Aug 29, 2012 17:43:27 GMT
Good post Pinky as we need to hear all points of view and then we can follow our own chosen path.
xxxx
|
|
|
|
Post by jacksfullofaces on Aug 29, 2012 19:08:16 GMT
I check them out between poker hands
Jacks
|
|
|
|
Post by jacksfullofaces on Aug 30, 2012 8:28:42 GMT
Pinky
You need a quick absorbent brain for both poker and idiot medical reports ;D
Jacks xxx
|
|
|
|
Post by jacksfullofaces on Aug 30, 2012 9:52:32 GMT
So if you are in menopause in your late fifites they are saying no to HRT to prevent osteoporosis. One size does not fit all.
Jacks
|
|
susan
Member
I refuse to join any club that would have me as a member - Groucho Marx
Posts: 749
|
Post by susan on Aug 30, 2012 10:05:42 GMT
I'm so glad I started on it in my early fifties. I am sure anyone who tries to go on at 60 or 60 plus has got no chance in the current climate. It just aint goint to happen. The best chance of staying on over 60 is if you already on it. xxxx |
|
|
|
Post by jacksfullofaces on Aug 30, 2012 12:09:32 GMT
|
|
|
|
Post by jacksfullofaces on Aug 30, 2012 13:08:06 GMT
Basically David Sturdee resigned from the comittee of safety of medicines because of a decision to no longer offer HRT to prevent osteporosis.The big problem with the British Menopause Society is that all of comittee members are NHS staff and tow NHS line
Jacks
|
|
|
|
Post by jacksfullofaces on Aug 30, 2012 13:11:13 GMT
So if you are in menopause in your late fifites they are saying no to HRT to prevent osteoporosis. One size does not fit all. Jacks Hi jacks No they are saying that they are recommending that you do not start it beyond the age of 60 for the sole purpose of preventing fractures. Once you're on it you can stay!! However that's what I meant about the data - these new recommendations are based on a re-examination of the old data - but they need more data otherwise we won't get anywhere because of the risks identified. I feel that's where the pressure should be - to make sure the right research is going on first - so that there is the right info to lobby politicians. And yes an arbitrary cut off date is ridiculous - although the new guidelines are less stringent re starting HRT ie the window of opportunity to start HRT within 10 years of menopause - which for me would be about 64/65 ish. And again yes all docs (GPs) should be re-educated - I mean updates should be mandatory for them, although how they keep up with it all is beyond me! Re Sturdee - yes he is one of the good chaps and has done years of research with Studd and Panay. I see the date was 2003 so he must have been protesting about the change in policy following the WHI study and all the hysteria about the dangers of HRT. So some of the academics are decent... pinky I am trying to say that since the recent re-evaluation I believe from what I've read, that we are moving forward - but the wheels of change are slow. I am optimistic though that things will continue to move in the right direction. Bellaciao x Personally I have seen no evidence to suggest that a change is in the air. My own GP told me PCT policy is not to offer HRT. Studies, studies and more studies just delay change through procrastination. |
|
|
|
Post by jacksfullofaces on Aug 30, 2012 15:09:45 GMT
The NHS also has a habit of practicing penny pinching and seem happy to force statins with associated side effects down the throats of anyone aged over fifty.
When the BMS starts actively lobbying then maybe I would donate to the cause - until then the money remains in my pocket.
Jacks
|
|
