A reader recently contacted me and asked me about the relationship between Hormone Replacement Therapy and exercise and specifically if she needs to exercise if she is taking Hormone Replacement Therapy (HRT).
Hormone Replacement Therapy and Exercise: The Question
I have recently purchased your exercise book (twice actually, kindle and now hard copy!). I am 56 and recently had a DEXA scan showing -3.0 T in the spine (Ok in the hip). I assume menopause has quite a lot to do with it, but thought dietary factors might too (mostly plant-based diet the past 5 years). I used to have very good bone density pre-menopause, so my loss has also been at a very high rate.
I have been wondering about HRT (Hormone Replacement Therapy), but have reservations based on cancer history so was hoping to turn the bone loss around without medications by increasing animal protein and weight bearing exercise (I have always been active, and a walker, but not much strength training).
But my question is: are you saying that despite the fact that you have always done a lot of weight bearing exercise – in fact exactly the exercise that you prescribe in your book – this has been insufficient to stem your own bone loss during menopause?
Because if that is so, then I am probably wasting time by just trying exercise and should opt for HRT. I can’t afford to lose yet more bone in the spine.
Hormone Replacement Therapy and Exercise: The Answer
Great question. You cannot build bone on hormones alone. Nor can you build bone only through good diet. You also need a variety of exercises that target all of your bones.
Bone quality, bone density and consequently, bone strength, are all products of hormonal balance, exercise and diet (as well as good genetics).
Bone health mirrors your activity level, your diet, your hormonal status and your general health. If one is lacking or weak it impacts the effect of all the others to be able to build bone to it’s optimum level.
This is why during puberty when a child has a surge of hormones in their bodies, the opportunity to build bone is at it’s greatest as long as they exercise and play hard, and have a bone healthy diet.
The same goes for menopause but in reverse when it comes to the hormones. By taking BHRT (Bioidentical Hormone Replacement Therapy) you are trying to reduce the effect of your own hormonal decline. It becomes more important to optimize your nutrition and exercise. They all play an important role.
Since you mention that your hip is okay you obviously had the nutrition and hormones to build bone and your hip scores are good because of the choice of exercise you made throughout your life.
Keep up whatever you have been doing for your hip.
You are right that you cannot afford to lose more bone in your spine. Walking does not help build bone in the spine. As you noted, you need more strength training. Focus on the exercises in my book that identify the spine as the target bone.
As far as BHRT, you need to discuss this with your doctor. Weigh the risks and benefits and do what is right for you.
During the first seven to ten years of menopause, your body is adapting to the loss of hormones. This is why women lose the most bone during this period. Without hormones, it is very difficult to build bone. Your goal should be to maintain bone and if you are “maintaining” you are “gaining”.
With or without hormones, specific exercises will optimize your bone health.
Also, please follow the suggestions in the daily activity guide. (There is link to the daily activity ebook in your Exercise for Better Bones book).
For more information, check out my Osteoporosis Guidelines.