“Why would you start HRT at 54-and-half, and happily free of menopause symptoms?” This is a good question.

It is the nub of why this was a difficult, yet clear decision for me.

Difficult because I had navigated the stormy seas of perimenopause without it, come out the other side more solid and on an even keel, and with a healthy heart.

Clear because my bones didn’t remain solid!

I had my last menstrual bleed at the age of 47/48 (those of you counting the days may be surprised to hear how you will forget!). This is not officially early menopause, but it’s on the early side of average (which is age 51).

There were a few rocky years (45-49) and though there were times when emotional symptoms were raw and hard to handle, they had difficult life causes (unrelated to hormones) which HRT couldn’t have fixed. Sleep was pretty tricky too. Brain fog caused me some difficult moments and hurt.

But through all this time I was developing Yoga for Menopause and Beyond and had so many tools at my disposal to support me. I had so much knowledge that helped me see the wood for the trees. And I had wise friends, colleagues and family members upon whom I was able to lean.

I knew this turmoil was partly because my body was being tossed around in an unfamiliar sea of hormones, the currents changing all the time. I knew it would find its way to understand this new territory.

And it did. My body came out the other side into calmer waters, where I feel more emotionally stable, and in December 2024 my doctor has, after a number of tests, indicated that my risk of cardiovascular disease is at 3% which is a fraction of what the average risk is for women my age.

BUT!

In 2022 a DEXA scan showed that I have osteoporosis (low bone mineral density (BMD).

My lumbar spine is small. My trunk is small! It’s no surprise that that’s the worst affected. In fact my “hip” is stronger, only in osteopenia range (actually the femoral neck is what is being referred to when you are told you have low bone density in your hip).

What you might not be aware of is that the level of BMD in my spine is low enough that it is very likely that I had osteopenia, even osteoporosis before menopause. Menopause hastens BMD loss, but I have other risk factors: a small body, small bones, 13 years consuming almost no dairy (you can get calcium in plants, but in my 20s I wasn’t concerned or ensuring high calcium plant foods!), higher than optimal alcohol consumption in late teens and early 20s (though not higher than average for most at that age), family history, and a severe adverse event in my youth (the deaths of my parents). I also never did strength training.

You might be surprised because I am very active: climbing hills & mountains all my life, lane swimming, yoga for 25 years, a patch of running in my 40s and dancing ALL THE TIME and wildly!

Sometimes it’s the luck of the draw folks!

So, what to do? After my first DEXA, after dealing with the shock and sadness, I began with dietary changes (more calcium, protein, Vit D and collagen), jumping 50 times per day, and researching like crazy, training in an exercise protocol for people with osteoporosis, and developing Yoga for Bone Health teacher training (seeing a pattern here!).

After a year, I surrendered to taking up strength training, which I did with successes and frustrations: I kept getting injured, or inflamed systemically and/or in isolated tissues, which is not uncommon in post-menopause when we take on strength work. But I kept at it, developing a level that didn’t injure me and was sustainable.

When time came for my follow-up DEXA, I felt that I had done all that I could do THAT WAS REALISTICALLY POSSIBLE TO CONTINUE. This is key! If I had devoted 2 years to absolutely every intervention known to humanity, and strength-trained to a high level, I ran the risk of dropping it all as soon as I saw an improvement. What we take on HAS TO BE SUSTAINABLE LIFELONG, especially with osteoporosis.

Sadly my second DEXA 2 years later showed further deterioration in my spine.

See my next blog to discover the choices I had, and what made me choose HRT, alongside continuing with dietary and strength supports, and why that medical choice was difficult, and remains on a trial period!!

If you would like to train with me you can click the links above (at the relevant trainings linked in bold), or you can join me for your own care. I work one-to-one helping people WITH osteoporosis (and/or other common movement issues 50+) or via my Yoga and More for Menopause and Beyond membership. Click the bold text to see the relevant options.