One of the most clinically significant effects of menopausal estrogen decline is bone loss. Related resources include menopause treatment, perimenopause care, hormone testing, and our hormone symptoms guide. During menopause, women experience hormonal changes that affect many parts of their body. After a steady supply of estrogen and progesterone during their adult life, women start to lose these hormones in their perimenopausal stage.
Menopause begins after one year passes from the last menstrual period. Menopause is characterized by low levels of reproductive hormones including estrogen and progesterone. These hormones contribute to every woman’s health. In addition to their role in regulating reproductive function, they also play a role in bone health.
Estrogen is a key regulator of bone breakdown and remodeling. Normally, estrogen stimulates bone-producing cells called osteoblasts while inhibiting others that break down bones. When estrogen levels start falling during menopause, bone mineral density (BMD) deteriorates quickly. A decrease in bone density results in osteoporosis – a musculoskeletal disease characterized by weak, fragile bones and a higher risk of bone fractures.
In osteoporosis, as bone density decreases, some bones can collapse or break more easily. Women with osteoporosis most commonly experience symptoms in their hips, wrists, ribs, and spine. For example, vertebra can collapse resulting in back pain, loss of height, and a stooped posture. Pain occurs during physical activities such as walking, standing, or bending movements.
Due to their diminished estrogen levels, menopausal women are more susceptible to develop osteoporosis. They typically lose around 20 percent of their bone density during the first five to seven years after menopause. However, other can experience a slower or faster decline rate.
To accurately evaluate bone density, menopausal women can do several tests to check their bone health. The most common BMD diagnostic test is the DEXA x-ray scan. The DEXA scan measures bone density in the form of a T score. T scores of -1.0 and higher are normal whereas scores ranging from -1.0 and -2.5 indicate weak bone health, or osteopenia. Women with T scores lower than -2.5 means they have osteoporosis and require treatment.
Hormone replacement therapy (HRT) can help alleviate the majority of menopausal symptoms. HRT protocols replace the lost estrogen and progesterone with external bioidentical hormones. After administering HRT, estrogen levels begin to rise again, leading to a decrease in menopausal symptoms.
HRT preserves bone during menopause. Study findings show that women who start HRT in their late 40s can prevent the drastic drop in bone density, thus lowering bone loss and fracture risk.
At Hormone Replacement Therapy, Dr. David Nazarian and his qualified medical staff provide HRT treatments for perimenopausal and menopausal women. Prior to starting HRT, women discuss their menopausal symptoms with a specialist first. A detailed medical history is required to assess duration and severity of symptoms as well as preexisting conditions.
HRT is not suitable for all women. For example, women with a history of heart disease or breast cancer may not be eligible for HRT due to its side effects. It is important to disclose all medically relevant information with your doctor.
A decrease in bone mass or osteoporosis is not only common in postmenopausal women, but also men, especially old men. Certain factors are the same in men and women such as exercise, diet, and medical conditions. However, low testosterone levels are the most common cause of decreased bone mass in men.
When women enter menopause, a decline in their estrogen levels occurs. This decline results in accelerating the thinning and loss of trabecular bone, which is the spongy part inside the hard cortical bone.
The bone loss in men is related to the decline in producing testosterone and estradiol, which is a type of estrogen. Men do not experience trabecular bone loss. Instead, they experience trabecular thinning. Therefore, the rate of bone loss in men is slower than in women and the loss of bone mineral density is smaller.
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After the age of 40, testosterone levels start declining fast. When men reach the age of 70, the bone density decreases. Men do not experience as many hormonal changes as women. However, osteoporosis in most men results from low hormonal levels, especially testosterone.
Many factors contribute to testosterone deficiency including:
The decline in hormone levels in men is not as significant as in women, especially after menopause. However, it can be enough to have negative effects on bone mineral density. Age, testosterone deficiency, and decrease in bone mass are connected in old men.
Prostate cancer leads to testosterone deficiency and cancer treatments, which usually include hormonal therapy, also feeds off of testosterone.
Long-term treatment using glucocorticoids is usually used in asthma and rheumatoid arthritis. It is a type of steroid that reduces testosterone levels significantly in the long run.
Hypogonadism means that the man’s body cannot produce enough testosterone. Usually, men with hypogonadism are born that way and the condition may develop due to certain illnesses or injuries.
Lifestyle changes including exercising regularly and following a healthy diet are the first line of treating osteoporosis. Medications may be added later if the condition does not improve over time.
Men who suffer from a significant decrease in their bone mass should consider additional options including testosterone replacement therapy.
Testosterone replacement therapy of TRT is the best option for men who have low testosterone levels. It is a hormonal replacement therapy that can be administered , transdermally through patches or a gel, via implants, or through injections.
TRT is used to treat nearly all conditions caused by low testosterone levels including a decrease in bone mass, hair loss, low sex drive, and metabolic problems.
Studies show that men with osteoporosis who undergo TRT show a significant increase in their bone density. Once testosterone reaches its optimal levels, the decrease in bone mass reverses.
Bioidential hormone treatment with estradiol/estrogen, progesterone and testosterone can help reverse and prevent osteoporosis in women.
If you are experiencing a decrease in your bone mass or have been suffering from osteoporosis for a while, it may be time to consider testosterone replacement therapy. Our Testosterone Replacement Therapy Los Angeles will help you to make your bones as strong as they used to be.
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David Nazarian, MD explains why a low testosterone result in a younger man does not automatically mean TRT, including fertility, endogenous production, lifestyle factors, and when alternatives may be considered.
David Nazarian, MD discusses how the menopause hormone therapy conversation has evolved, what changed after the Women’s Health Initiative, and how he approaches benefits, risks, screening, and monitoring with patients.
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David Nazarian, M.D., is Board-Certified in Internal Medicine by the American Board of Internal Medicine and has completed advanced bioidentical hormone replacement therapy training through WorldLink Medical. He provides physician-led hormone evaluation and individualized care for women and men, with an emphasis on comprehensive assessment, patient education, safety, and ongoing follow-up.
Hormone Replacement Therapy LA provides physician-led hormone evaluation and individualized care with David Nazarian, M.D.
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