Q & A with Dr. Judith Reichman continued
Q: What about the woman who never took estrogen?
A: As far as a woman who's never taken estrogen, and she hits sixty or seventy and she says 'You know my doctor never told me about estrogen, and now I'm reading all this stuff about it, should I start it?'
And my answer would be, 'Let's look at your risk factors, see if you have risk factors for coronary vascular disease, it might be a very good idea, if you're developing osteoporosis or osteopenia and your bone density is low…hey this is one of the best things you can do for your bones.'
Q: Will taking estrogen help to rebuild bone loss?
A: Yes. What it does is all of the drugs that are currently out for treatment of osteoporosis help diminish bone resorption. And estrogen does it probably better than all the other drugs out there. When you stop making those little holes in the bones, then with time the holes that are there begin to fill up and that's why you can build back some degree of bone… what you're doing is filling up the holes that are there and not making new ones.
Q: My mother, who is 71, had a hysterectomy over 20 years ago. She never took estrogen. I believe she probably has osteoporosis, although she's never been diagnosed, because she's shorter and she walking is difficult for her. What would you advise a woman like my mother?
A: She should have a bone density and if indeed-- I'm sure she does have osteoporosis, then she has to talk to her doctor. She might be an excellent candidate for estrogen. If she really has very bad bones we are in some cases adding to the estrogen-- Fosamax--because in combination they work better than by themselves.
If for some reason she doesn't want to take estrogen or can't take estrogen then you've got some other excellent alternatives. In addition to the Fosamax, you can do fosamax, or she can consider the raloxifen (Evista®) which is shown to be very good as far preventing the resorption.
Miacalcin is a nasal spray that also diminishes resorption rates in women who are post menopausal at least five years. And then there's also the issue of having to make sure she takes enough calcium because none of these will work if you don't get enough 'cement' from which to build a support system and that cement is calcium.
In your mother's age group any woman who is either menopausal and not on estrogen, or over the age of 65 and even if she is on estrogen, needs 1500 mg of calcium a day. Very important to take it in divided doses because if you take it all at once you can't absorb that much.
And there are wonderful calciums out on the market. I know one of the new ones that I really like, and it's the only way I got my daughter to take calcium, is the Viactiv because it's this chocolate or cappuccino tasting chew like a tootsie roll. And then a lot of my patients I tell them to take calcium and they say 'I'm not going to swallow those horse pills, I'm not going to take Tums.' But then, I give them a sample of the Viactiv and they say 'Oh, this is good, I can do this.'
So your mom, in her age group, should take it 3 times a day. She should be sure she is getting Vitamin D. As you get older your skin doesn't convert Vitamin D from sunlight as well nor do your kidneys make it as well so you need more Vitamin D. So instead of what we tell the usual woman to take 400 mg, you need 800 mg.
And then weight-bearing exercise, even in elderly women just doing weight bearing fifteen minutes, five times a week, plus calcium, plus Vitamin D, has been shown to significantly reduce fracture rates, even women in nursing homes who already have significant osteoporosis.
Q: My mother walks very slowly…
A: She can go ahead and get light weights, and do maybe some light weight lifting. And what helps in the beginning is to have her work with a physical therapist, just to show her what she can do without hurting herself and let her continue at home. But, I would say for her to do the weights three times a week for fifteen minutes. Plus walking--she should be walking thirty minutes a day even if she doesn't walk fast. If she can get her heartbeat up that will not only help her fitness, but will help her bones.
Dr. Reichman's book "Relax This Won't Hurt - Painless Answers to Women's Most Pressing Health Questions"
Next page > Natural progesterone vs. synthetic progestin, Testosterone > page 1,2, 3
|
|
|
|
|
|
|
||
|
|
