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Can Menest Be Taken For A Long Duration While Having Osteoporosis?

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Posted on Mon, 2 Jan 2017
Question: MY QUESTION: Should I continue taking MENEST as a means of controlling bone loss? I have been taking Menest 0.3 mg since 2000 after radical hysterectomy. My new (Primary Care Dr) insists that I stop taking Menest, which is in direct conflict with my recently retired Rheumatologist. Began taking the Menest 0.3mg, prescribed by OB/GYN, after a total hysterectomy several years ago. OB/GYN retired and my Rheumatologist (who is also an Internist and Osteopath) continued with the therapy. I have Osteopenia, and have broken bones in my foot, have skeletal problems in hands, feet, hips, back and knees. I had Spinal Surgery in 2010 on my L4 and L5 discs. My Rheumatologist recommended that I continue the Menest therapy for the long term. He said he has given it, long term to women in their 70's and 80's to protect against brittle bone fractures. I have never had any problems with Menest. The company stopped production for about a year and I was given another estrogen,but I did NOT tolerate it and did not take it. Once Menest came back on the market, my Rheumatologist proscribed it for me. I have lost 4 inches in my height since my hysterectomy. Last year (early 2016) when my Rheumatologist retired, he suggested that I need to continue Menest. He said the need to continue out weights the risks to my back and feet. I had a mild stroke in 1998, was placed on Warfarin and have my PT/INR monitored monthly. That was another reason that the Rheumatologist said it would be fine to continue Menest. He said it has not interfered with my Warfarin therapy and since I have my levels monitored, he feels it is safe for me to continue. NOW, my Primary Care Doctor insists that I discontinue the use of Menest. He said I can take other medications to control my bone loss. I maintain that since I have not had any problems with Menest, it is better to continue taking it, instead of trying another medicine. I do not tolerate many medications. I have allergies to several medicines (sulfa drugs, statins (Zocor, Simvistatin, Lipitor, Crestor-I ended up in the ER after one dose of Crestor). I have severe hair loss which started after taking the various Statin drugs. Hair has been better since stopping all statins. I have Raynaud's Phenom. and take a combination of Vasotec and Procardia XL to control some severe symptoms. Many years ago, I had Myocarditis but was treated and regained my health. I have had many issues with blood problems,skeletal problems, allergies that I don't want to change my medications. They are working and everytime my PCP pushes a new drug my way, I end up have a reaction to them (specifically talking about th eStatin drugs for high BP). I would like to share your comments with my PCP. I look forward to your reply. Thank you
YYYY@YYYY
doctor
Answered by Dr. Naval Mendiratta (2 hours later)
Brief Answer:
Osteoporosis

Detailed Answer:
good evening

thank. you for writing on health care magic

I have gone through your history. You have had a tough time with many complications and thanx to your will power, you have managed it well.

As per your query... Considering multiple fractures you have had, in the foot and spine(since you say your height has reduced)... Estrogen was a good drug when it was introduced but it s role in preventing fractures of the hip has not been good. With your age and history of fractures the main concern does remain hip fractures as it increases morbidity. .Moreover you have taken it for long, and most drugs reach their maximum Level after which effectiveness goes down.. So we always give drug holidays...

Secondly I would like to know your Dexa scan result as well. the one done recently and the one done before that. So we can compare and see if there is worsening..If it is improving or static at least we know the drug is working..

3. have you tried any other drugs for prevention like zolindronic acid or ibandronate?

I understand your concerns about trying new medicine but If we can prevent any further fractures with better drugs, that Is something we should do. Prolia would be my first choice considering convenience...The other option is teriparatide but that involves daily injections...

Do let me know these queries and would guide you further from herw

regards
Dr naval
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Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 754 Questions

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Can Menest Be Taken For A Long Duration While Having Osteoporosis?

Brief Answer: Osteoporosis Detailed Answer: good evening thank. you for writing on health care magic I have gone through your history. You have had a tough time with many complications and thanx to your will power, you have managed it well. As per your query... Considering multiple fractures you have had, in the foot and spine(since you say your height has reduced)... Estrogen was a good drug when it was introduced but it s role in preventing fractures of the hip has not been good. With your age and history of fractures the main concern does remain hip fractures as it increases morbidity. .Moreover you have taken it for long, and most drugs reach their maximum Level after which effectiveness goes down.. So we always give drug holidays... Secondly I would like to know your Dexa scan result as well. the one done recently and the one done before that. So we can compare and see if there is worsening..If it is improving or static at least we know the drug is working.. 3. have you tried any other drugs for prevention like zolindronic acid or ibandronate? I understand your concerns about trying new medicine but If we can prevent any further fractures with better drugs, that Is something we should do. Prolia would be my first choice considering convenience...The other option is teriparatide but that involves daily injections... Do let me know these queries and would guide you further from herw regards Dr naval