Protect the skeleton before the first fracture.
Estrogen is the most important hormonal regulator of bone in women. Its loss is the moment to measure, prevent, and — when needed — treat.
What happens to bone after menopause
Estrogen is the most important hormonal regulator of bone remodeling in women. With its loss, bone resorption outpaces formation and bone density falls — most rapidly in the first several years after the final period. The result is a measurable rise in fracture risk, particularly at the spine and hip. This happens silently; the first symptom of osteoporosis is usually the fracture itself.
Screen before the fracture
We screen with bone density testing (DEXA) — available within our parent practice — timed to your risk profile rather than a birthday, and we track response to treatment over time. Risk factors that move screening earlier include early or surgical menopause, POI, family history of hip fracture, steroid use, thyroid disease, and low body weight.
Prevention and treatment, honestly ranked
Hormone therapy prevents the rapid postmenopausal phase of bone loss — in the Women's Health Initiative it reduced hip fractures by roughly a third — and for women within ten years of menopause with symptoms, fracture protection is a meaningful added benefit. But for established osteoporosis or very high fracture risk, bone-specific medications (bisphosphonates, denosumab, and the anabolic agents teriparatide, abaloparatide, and romosozumab) are more effective, and that is what we use. Hormone therapy is preventive; it is not first-line treatment for existing osteoporosis. Weight-bearing exercise, adequate calcium and vitamin D, and fall prevention round out every plan.