Bioidentical Hormones for Osteoporosis (Bone Loss)

After menopause, osteoporosis can occur – a condition where bones become weaker. They lose density, size, and flexibility. Particularly affected are thin women, as well as white and Asian women, or those who enter menopause early. Hormonally caused osteoporosis can be treated with bioidentical hormones.

What is Osteoporosis, and how does it develop?

Osteoporosis is a bone disease that progresses gradually. The bones become less dense and flexible, making them more susceptible to fractures. Often, those affected don't notice anything about the disease for a long time – first signs such as decreased height, hunched posture, back pain, or easy bone fractures usually only appear after years.

Our bones are like a constant construction site: Specialized cells break down bone tissue (osteoclasts) while others rebuild it (osteoblasts). However, in osteoporosis, breakdown predominates, and bone tissue gradually loses its strength. The strength and structure of bones are complex and vary depending on their function in the body. Hormones like estrogen and testosterone are important regulators in this balance of bone formation and breakdown.

Hormonal influences on bone health

Women around menopause experience accelerated bone loss. This is because bones break down more quickly, while simultaneously less new bone tissue is formed. Women from age 45 lose between 1 and 4% of their bone tissue per year, so that by age 65, one in three women, and by age 75, one in two women suffer from osteoporosis.

Estrogen plays a central role here: When there is a deficiency of this hormone, the bone-degrading cells live longer, while the bone-building cells have a shortened lifespan. Normally, the hormones estrogen and progesterone help keep our bones stable by maintaining a balance between formation and breakdown.

However, during menopause, these hormones decrease significantly, leading to a declining rate of bone turnover – a key factor in the development of osteoporosis.

Risk Factors

In addition to genetic predisposition, there are several lifestyle factors that can increase the risk of bone diseases like osteoporosis.

These include:

• Women with absent menstrual periods (e.g., competitive athletes)
• Smoking and excessive alcohol consumption
• Lack of exercise
• Early menopause that can be triggered by surgeries or serious illnesses
• Being underweight
• Long-term use of certain medications, such as cortisone
• An unbalanced diet
• Lack of sunlight (vitamin D deficiency)

Treatment of Hormonal Osteoporosis

After menopause, when estrogen production in the body decreases, osteoporosis can develop. Unlike osteoporosis that can occur before or shortly after the onset of menopause, osteoporosis that occurs more than 5 years after menstruation stops is best treated with lifelong bioidentical hormone therapy and vitamin D. This therapy is individually tailored, not necessarily in the form of Rimkus® capsules.

Although taking bioidentical hormones for life may be inconvenient, the results are often more effective and associated with fewer side effects than conventional osteoporosis medications.

Monitoring & Treatment Success

The effectiveness of hormonal treatment is monitored through DXA measurement (Dual X-ray Absorptiometry). This X-ray method measures the minerals in the bones and shows whether they have become stronger or weaker. Success is also evident in whether bone fractures that occur without obvious cause become less frequent or no longer occur at all. Further information can be found on our page about the treatment process.

Osteopenia is a term that describes a lower than normal bone density value, measured at two points of the skeleton. However, it doesn't indicate how resilient the bones actually are, which is why it's not as clinically significant.

The DXA measurement compares a person's bone density with the average of a 20- to 29-year-old population. The femoral neck and lumbar vertebrae are particularly examined, as these show signs of osteoporosis earliest. Although DXA measurement is considered reliable, it only evaluates density and not other bone properties.

In Germany, DXA measurement is typically performed at the start of hormone therapy and then after two and five years to monitor success. It is considered the main method for assessing progress, supplemented by ultrasound measurements of the heel bone, which are however less informative than DXA measurement.

To complement the assessment of vertebral fracture risk, ultrasound procedures (BMD Heel) can be used, though they cannot replace the much more sensitive DXA method.

A Bone Density Measurement Can Be Your First Step to Better Health

Every woman who might be at increased risk for bone problems - whether due to competitive sports, being underweight, or menstrual cycle irregularities - should consider having a bone density measurement through a DXA examination. 

This important step allows us to understand your unique bone health story. Based on detailed laboratory analyses, we can then begin a personally tailored therapy with bioidentical hormones if needed, supporting your body's natural balance and strength.

Alternative Treatment Forms

Every healing journey is unique, and it's important to understand all available treatment options. While conventional medications are available, they require careful consideration:

• For example, bisphosphonates
• For example, strontium ranelate

... which are used for treatment, can become ineffective over time and may cause serious side effects (such as gastrointestinal complaints, jaw osteonecrosis, osteonecrosis, atypical femoral neck fractures, renal toxicity, etc.).

Therefore, they should not be readily combined with bioidentical hormones or other hormone treatments.

For those with an increased risk of breast cancer, medications that influence estrogen receptors may be appropriate. These belong to the group of selective estrogen receptor modulators and aim to reduce breast cancer risk.

In cases of increased breast cancer risk, estrogen receptor-stimulating medications are used, see also: selective estrogen receptor modulator therapy.

Alternative Causes of Osteoporosis

Non-hormonal osteoporosis can be medication-induced.

Medications that can induce osteoporosis:

• Birth control pills
• Hormonal IUD
• Antidepressants
• Anxiolytics
• Proton pump inhibitors (PPI)
• Cortisone
• Warfarin