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By Adwina Jackson

Apart from taking appropriate amount of mineral supplements and getting regular weight bearing exercise, intake of a low dose of oral contraceptives during perimenopausal stage (stage immediately before menopause comprising of 3-5 years) is apparently linked to enhancing the bone density. Studies indicate that the contraceptives aid averting the acceleration of bone loss and hence the impending risk of osteoporosis that commonly occurs during menopausal/ postmenopausal years.

One of the studies revealed that among post-menopausal women, an intake of oral contraceptives led to an enhancement in bone mineral density and a reduction in the levels of blood cholesterol. Most researchers are of the belief that oral contraceptives are more efficient than the hormone therapy (HT) for menopause. Although both oral contraceptives and HT enhance bone mineral density, but with oral contraceptives, there is a better overall deceleration of bone loss. The latter also confer a larger decrease in low-density lipoprotein (LDL) cholesterol, which is the so-called bad cholesterol and responsible for various heart problems. Although this study needs more confirmation, but many researchers consider oral contraceptives will soon come up as an alternative for HT for keeping healthy during postmenopausal years, especially in context to menopausal/ postmenopausal osteoporosis. However, since oral contraceptives too aim at altering hormonal levels of body just like the HT, oral contraceptives too impart side-effects, most of which are in common to HT.

Side effects of oral contraceptives:

Nausea or vomiting

Breast tenderness or swelling

Weight gain

Irregular bleeding /spotting

Hormone therapy (HT) is the best option to prevent osteoporosis among postmenopausal women. The therapy involves supplementation of either estrogen alone or in combination with progesterone. Ovaries produce these hormones and they regulate various physiological processes. One of the important roles of estrogen is in bone turnout, being responsible for blocking the resorption of bone calcium into the bloodstream. However, during the onset of menopause, the ovaries are no longer able to produce sufficient amount of estrogen and following postmenopause, ovaries produce almost no estrogen. Therefore, this is the time when bone loss accelerates among women since in the absence of estrogen, calcium resorption begins from bones, increasing the risk for osteoporosis. In men, the hormone testosterone plays a role analogous to estrogen in females on the bone. Thus, when there is a decline in testosterone levels (which happen around the age 65-70), bone mineral density declines. Thus, among men too the testosterone supplementation is given to prevent bone loss. However, the conventional HT particularly refers to supplementing estrogen (alone or along with progesterone) to menopausal women. FDA has not approved use of testosterone to treat osteoporosis.

Estrogen in HT can be given in the form of tablets, cream, injections or vaginal ring. You must talk to your doctor about the form that would best on you.

Another hormone that doctors generally give along with estrogen is calcitonin. This hormone is produced by thyroid and its function is to help bones absorb the calcium. With age, the production of this hormone by thyroid declines as well. Thus, supplementation of estrogen along with calcitonin works great in most postmenopausal women to prevent the bone loss. While you are on these hormones, you must ensure adequate intake of calcium and vitamin D.

Prevention of osteoporosis by HT is its added advantage of the therapy. If you have a severe bone loss, your healthcare professional may prescribe you drugs typical to treat or prevent the progression of osteoporosis as described in the next chapter.

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