Gelded (imported) wrote: Tue Jun 22, 2021 4:12 am
But it seems to me, and I will ask my endocrinologist, that there are treatments without hormones to protect against osteoporosis.
I have been a chemical eunuch since 2009. For quite a few years, I went with no hormones at all. My libido went down so much that I only needed release about once in 3-4 months. However, fully 10 years later, in 2019, I convinced my doctor to order a bone density scan and sure enough I have developed osteopenia (a precursor of osteoporosis). Since then I was prescribed both testosterone gel and Fosamax, which directly slows/stops further deterioration of osteopenia.
I did not like all the side effects of the return of T. I stopped T for a while and tried Estrogen gel. It was giving me similar level of libido.
As for your question of non-hormonal treatment of osteoporosis, these drugs have a lot of severe side effects on their own. And their useful life is about 5 years, after which their risks far outweigh the benefits. They can cause sudden fracture of the femur, the thigh bone. And they can cause osteonecrosis of the jaw, which is death of the jaw bone after any significant tooth procedure for something as simple as a tooth extraction. (As my mother had to get a badly decayed tooth, but she had been on Fosamax and then other similar drugs, the surgeon was reluctant to extract the tooth. Luckily, there was an easy workaround for her. But evidently, it is a frequent and serious enough risk that there is a department for these conditions within Stanford Health. As such, I went through a crash course on the risks of these osteoporosis treatments.)
In short, osteoporosis medications ARE NOT for preventive use, because they have serious and dangerous side effects and have limited useful life for each of them. They should be kept for when we really need to treat osteoporosis (and not really appropriate for osteopenia either).
Fosamax, in particular, as in any oral medications, have a long half life of something like 10 years. In other words, the dangerous side effects stay with us even after we stopped the medication for decades.
My doctors persuaded me take a "holiday" on Fosamax and just rely on my testosterone gel.
And here is the answer to the question from @4everLimp about what is the lowest dose to maintain bone health without feminization if taking estrogen, and return of strong libido if taking testosterone.
Every person's mileage differs. The way I figured that out for myself was by working closely with understanding doctors. I reduced my testosterone to a comfortable level libido wise. And I kept on checking my testosterone levels in my blood. I maintained the lower level within the acceptable range. And I kept getting bone density scans annually to confirm that my osteopenia has stabilized (actually improved a bit). (Although most insurance covers these scans only every 2 years, my doctor was able to convince them to approve annual scans if actively treating osteoporosis.)
Both my PCP and endocrinologist cannot tell me what that magic "lowest dose" is for me. We have to do trial and error and constant monitoring to find that for me.
Hope this is helpful to your consideration.