By Dr. W. Gifford Jones
July 2, 2001
What a change a few weeks can make in the management of menopausal problems! For decades millions of women have been prescribed hormone replacement therapy (HRT) to treat osteoporosis (brittle bones). Recent studies indicate HRT can lead to an increased risk of breast cancer and cardiovascular problems. Fortunately, there are other viable options for treating this common disease.
Osteoporosis is a disease of bones, which like other living tissues, are in constant change. Early in life more bone is formed than lost. Later the reverse is true making bones more fragile with increased risk of fracture.
But because of the latest HRT reports many postmenopausal women will now look to other long-term therapies to fight osteoporosis. Thankfully there are options which can help women keep their hearts healthy and cancer risk low.
Selective Estrogen Receptor Modulators (SERMs) are a relatively new class of non-hormonal agents. Evista (raloxifene) is the only SERM available to both prevent and treat established postmenopausal osteoporosis. It is ideal for postmenopausal women who are at risk of developing osteoporosis and wish to prevent it. It is also effective for women who already have osteoporosis and want to decrease their risk of fracture.
And research shows the effect of fracture reduction is seen early in treatment. Studies have shown a 68 percent reduction in vertebral fractures within in one year of starting treatment.
Studies have also shown that in women with osteoporosis Evista reduces their risk of vertebral fracture, one of the earliest and most common osteoporosis fractures types, by as much as 55 percent.
One of the main precepts in medicine is "Do the patient no harm". Studies to date show that Evista does not cause cardiovascular problems. In fact, for women at high risk of developing cardiovascular troubles Evista decreases the risk by 40 percent. Part of this decrease may be due to Evista's beneficial effect on cholesterol levels.
What about the ever-present fear of breast cancer? Fortunately Evista has no adverse effect on breast tissue. Rather, a study released last year indicates that after four years of treatment, Evista reduces the risk of breast cancer by 72 percent for some women. And in estrogen-receptor-positive invasive breast cancer, the most common type in postmenopausal women, risk can be reduced by up to 84 percent.
Evista, unlike estrogen, does not have any effect on uterine lining. This means no bleeding or increased risk of developing cancer of the uterus.
Evista is contraindicated if you are or might become pregnant, are nursing, have liver problems or a history of blood clots.
Bisphosphonates are another type of non-hormonal treatment to prevent and treat osteoporosis. They must be taken on an empty stomach and the patient must not lie down , or take any liquids, food or other medication for 30 minutes.
HRT can still be useful for menopausal women who suddenly experience severe emotional problems, flushes and insomnia. Taking an estrogen supplement such as Premarin for a short period of time will continue to be the best treatment for menopausal blues.
What this means is that there's now more than one treatment for menopause. Short-term estrogen will quickly relieve flushes and restore nerves to normal. Evista and other medication can then be prescribed to decrease the number of postmenopausal women who would face a bleak future with fractured hips and vertebra as a result of untreated osteoporosis.
Getting older is a risk factor for osteoporosis. But you're at increased risk if you happen to be Caucasion (white) or Asian, have a slender build or a family history of this problem.
Hip fractures can be lethal. Patients who survive are often disabled and never return to the quality of life they enjoyed before the fracture. Prevention is the key to circumventing this problem.
A primary method of preventing osteoporosis is the adoption of a healthy lifestyle. The trick is to start early in life. This means adequate amounts of calcium. The best source of this is three glasses of milk every day. The next step is to make it a life-long habit. Calcium supplements and vitamin D will also help to reduce bone loss in the elderly. And never forget that exercise not only builds a strong heart, but also makes bones stronger.
The worst scenario is that scary headlines force women to abandon all forms of treatment for osteoporosis. This is a grievous tragedy since osteoporosis has reached epidemic proportions in this country. Such a mistake would have major effects on both an individual's health and that of this nation.
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
Pre-2008 articles by Gifford JonesPursuant to Title 17 U.S.C. 107, other copyrighted work is provided for educational purposes, research, critical comment, or debate without profit or payment. If you wish to use copyrighted material from this site for your own purposes beyond the 'fair use' exception, you must obtain permission from the copyright owner. Views are those of authors and not necessarily those of Canada Free Press. Content is Copyright 1997-2024 the individual authors. Site Copyright 1997-2024 Canada Free Press.Com Privacy Statement