Bioidentical Hormone Therapy

The management of osteoporosis patients start with the diagnosis by rolling out secondary causes and then confirm it by measuring bone mineral density (BMD). After that, begin the treatment with lifestyle changes, pharmacological medications, and surgery for some fractures if needed. In this essay I will cover generally the diagnosis, treatment, and prevention of osteoporosis in five steps.

Osteoporosis, meaning porous bone from the Greek language, is bone disease that gradually and steadily wears down bone tissue and its living cells. This wearing down will eventually cause the cells of bone tissue to degrade and die, leaving their “scaffolding” to be the only things only bone together. Without living cells to take up a home in this scaffolding, minor injuries such as falls, bumping into objects, and pressure that would normally be completely and would not pose any threat to bone tissue suddenly becomes a real hazard that can easily pose a threat to one’s well-being. Osteoporosis affects a person skeletal system.

Osteoporosis is a treatable disease, but not a curable one. There are different types of treatment for osteoporosis. Some of the medications that can be taken for treatment of osteoporosis are estrogen, bisphosphonates, calcitionin, raloxifene, parathyroid hormone, and testosterone replacement (UCSF Medical Center, 2010). Some of the more common names for bisphosphonates are Fosamax, Actonel, Boniva, and Reclast (Mayo Clinic, 2009). These treatments are taken orally once a week or once a month. In addition to the medications, there is also the treatment of exercise and diet. With a diet high in calcium, stopping unhealthy habits, like smoking and drinking, and regular exercise can reduce the likelihood of bone fractures in people with osteoporosis (The New York Times, 2010). In Ms. Duckworth’s incident, it would be recommended that she increase the amount of calcium in her diet and exercise, and depending on the severity of the osteoporosis, medication.

As generally stated in the introduction, osteoporosis is a skeletal disorder that involves the strength and integrity of one’s bones. The WHO defines osteoporosis as, “a systemic skeletal disorder characterized by low-bone mass, deterioration of bone tissue, increased bone fragility, and its susceptibly to recurrent fractures.” 2 The most important factor to take into account when addressing osteoporosis is the mass of bone, also referred to as, bone mineral density (BMD). As bone mass begins to decline, typically in the older population, specifically postmenopausal women, individuals are at an increased risk for fractures.3 As a result of this serious condition, many people are affected by morbidity, mortality, and economic difficulty.1

This increase in bone loss results in the condition called osteoporosis. Osteoporosis in turn increases the susceptibility of bones to fractures. Studies have indicated that treatment with hormone replacement therapy is beneficial in reducing the risk of suffering from osteoporosis. The clinical trial carried out by Postmenopausal Estrogen/Progestin Interventions (PEPI) for three years revealed that osteoporosis was reduced in hormone replacement therapy. This study demonstrated that the independent use of conjugated equine estrogen (CEE) or in complex with progesterone analogs fostered an increased bone-mineral density. The Heart and Estrogen/Progestin Replacement Study (HERS) was carried out separately in about three-thousand women (Herrington 12). This study indicated that bone density was significantly higher in women who underwent the therapy. The women who had been assigned placebos showed a slightly higher rate of bone loss. This shows that hormone replacement therapy confers the benefit of alleviating bone loss and maintaining healthy amounts of bone minerals (PEPI;

There has been conflicting research and advice about the safety of hormones with the increase in the aging female population within the last twenty years (National Institute on Aging). Hormone therapy has demonstrated to be the most effective FDA approved medication in the relief of menopausal symptoms, but these benefits must be weighed against serious adverse effects that hormones can cause. Although many women differ in their response to hormone products, MHT has been universally linked to an increased risk of heart disease, heart attack, blood clots, and strokes. Concerns about the findings discovered in the clinical and observation trials performed on MHT, have left some doctors and women hesitant in utilizing MHT to combat menopausal

Felson, D. T., Zhang, Y., Hannan, M. T., Kiel, D. P., Wilson, P., & Anderson, J. J. (1993). The effect of postmenopausal estrogen therapy on bone density in elderly women. New England Journal of Medicine, 329(16), 1141-1146.

Only 27.4% of the women in the prevention group were taking prescription medication for osteoporosis. Among the treatment group, 58.1% of women were taking prescription medication that was related to osteoporosis. This study showed relatively low percentage rates of women that were prescribed medication to prevent and treat osteoporosis. This article states many times that patients are more likely to take medication related to the prevention or treatment of osteoporosis if the primary physician was a family physician rather than a

Osteoporosis is a secondary aging musculoskeletal disorder that increases bone degeneration and disruption of bone mineral development. A major challenge with treating osteoporosis lies in the difficulty of diagnosing it in the early stages, because no symptoms appear until an actual complication such as a bone fracture occurs. Thus, osteoporosis is known as a “silent disease” (Cosman, 2014). During the childhood years, bones normally grow in size and strength until the person’s peak bone mass has been reached at approximately 20 years old. Around 40 to 50 years old, men and women are affected by age related decline in bone mass (National Institute of Arthritis and Musculoskeletal and Skin Diseases, n.d.). Women above 40 years old and of Chinese or Caucasian ethnicity are of high risk for developing osteoporosis (Wilbiks lecture, 2014). Other risk contributions to the condition include old age, female gender, small body size, low calcium and vitamin D, decrease of estrogen, lack of exercise and genetics. A slender, thin-boned tall woman is at greater risk for osteoporosis compared to a woman with a proportional amount of fat, bone and height. To prevent the development osteoporosis, people who are at high risk should take preventative measures, and this guide suggests three methods that have been supported by various researchers: 1) Supplementing calcium into diet; 2) Changing lifestyle patterns; and 3) Quitting smoking. All these preventative measures have been shown to

Another recent article in the latest issue of the International Journal of Pharmaceutical Compounding is a nice summary on bioidentical HRT. The study compares randomized, controlled trials in human females (published between 1995 and 2010) looking at bioidentical and traditional hormone replacement therapy and their impact on cardiovascular and breast cancer risks. The study concluded that conventional hormone replacement therapy (the use of conjugated estrogens and

Due to their genetic composition women have less level of testosterone than men. The Center for Disease Control and Prevention (CDC) is a well-known and a creditable national health agency has attempted to access the link between various hormone including testosterone and osteoporosis. This article focused on hormone testing, and the impact different hormone have health including bone health. Although this article has recently been updated, it lacks substantial information to address the question. The information provided by the author is a basic evaluation of a series of steroids testing and discussion on the researches’ flaws. Unfortunately, the CDC did not have any better article on testosterone and osteoporosis. It could be improved by elaborating more on the effect testosterone testing and osteoporosis. Other Articles have better assessed the correlation between testosterone levels and the likelihood of developing osteoporosis in women compared to men. A peer-reviewed journal article entitled Premature Ovarian Failure: Women Sought for Testosterone Replacement Study tells us that testosterone is an important hormone in women. It further highlights the function and benefits of testosterone in women which including bone health. however, readers cannot find the notion that men have a tendency of developing osteoporosis due low levels of testosterone when reading

Hormone replacement might correct hormonal deficiencies and ensure optimal levels, but should not go above that. It should be a balance between hormones, which means that all hormones should be checked and corrected, not just one.

     Osteoporosis is a health ailment which causes bones to become so porous that they can break easily. Osteoporosis literally means 'porous bones'. The bones in our skeleton are made of a thick outer shell and a strong inner mesh filled with collagen [protein], calcium salts and other minerals. The inside looks like honeycomb, with blood vessels and bone marrow in the spaces between bone. Osteoporosis occurs when the holes between bone become bigger, making it fragile and liable to break easily. Osteoporosis usually affects the whole skeleton but it most commonly causes breaks or fractures to bone in the wrist, spine and hip.

Two French studies published in 2008 suggest that Bioidenticals are safer than conventional HRT. According to Dr. Kent Holtorf’s literature review bioidential hormones appears to be safer and more potent then synthetic therefore physicians may opt for biodenticals for now unless new data is available from new studies.”

There have been many advancements in health care for the general population as well as the elderly in recent times. One of the major health concerns that is being targeted right now is osteoporosis. Osteoporosis comes from bone becoming fragile because of bone mass being decreased. There are different forms of osteoporosis such as primary and secondary. Primary osteoporosis does not have a specific reason or disease associated with it, and secondary osteoporosis usually has to due with deficiencies and chronic medical conditions. Being post-menopausal also is a contributing factor linking individuals to this disease. Although this disease is prevalent in women, men should also be concerned. Studies have linked certain lifestyle choices such as smoking, alcohol use, and living a sedentary lifestyle to this disease. With the elderly population increasing vastly from year to year, osteoporosis is becoming ever so severe to this population, and also costly to society. There has been research done on different medications, vitamin therapies, and exercises that have proven to be helpful, but there is still much research to be done.