Several drug based menopause treatments have been used in attempts to prevent bone loss and weakening as well as the fractures that happen as a consequence, but there are problems with this approach.
First, most treatments need to be taken for a prolonged period, often several years, if they are to be effective. Second, the financial cost of these menopause treatments is not small, and several health agencies have concluded that it is still less expensive to treat the eventual fractures than to try to prevent them with medications. This may sound cynical, but the truth is that the costs are measured not only in direct cost of the drug, but also in the side effects that they bring, such as increased risk of other serious diseases such as cancer and blood clots that form in the legs and sometimes reach the lungs.
Third, because we can only be sure of the long-term effect of these drug based menopause treatments after very long-term trials, most companies will market them before their very long term effects and side effects are fully understood or appreciated.
This is not to say that drugs should not be taken at all, but the possible benefits must be carefully considered and weighed against the risk of side effects and the cost of the chosen menopause treatments. It is a choice that should be carefully discussed with your healthcare professional in the light of factors such as personal or family history of breast cancer, blood clots, heart diseases and other conditions that may be favorably or adversely affected by these drugs.
HRT Or Hormone Therapy
NT/HRT is based on the principle of restoring levels of sex hormones – particularly estrogen – to those that were observed before menopause. Recent results from long-term trials conducted by the Women’s Health Initiative (WHI) have put the good and bad effects of different forms of NT in perspective. One area of study was whether or not HT would enhance protection against heart disease and stroke and also against hip and vertebral fractures. The general conclusions were mixed. Long-term HT can reduce the risk of fractures (particularly those of the hip and vertebrae), but may increase the risk of breast cancer stroke and blood clots, and does not reduce the risk of heart disease.
Again, the only way to make a sound decision is through a careful discussion of the pros and cons of your particular situation with your healthcare professional.
Selective Estrogen Receptor Modulators (SERMs)
This family of drugs has estrogen-like effects on some tissues and anti-estrogen effects on others. One of the SERMs family, raloxifene (Evista), has been approved by the CSM for the treatment and prevention of osteoporosis. It has been developed to bind to the estrogen receptors in some cell membranes, and in this way stimulate the cells just as estrogen would, but without the side effects, since these drugs are not estrogens.
Raloxifene was designed to reproduce the effects of estrogen on bones, but without estrogens effects on breast tissue or the uterus. Raloxifene has been shown to prevent