The HRT That Prevents Osteoporosis Without Side Effects

Today’s article will be mainly about women’s health, because it’s about the tradeoff between:

• Menopause-mediated osteoporosis due to declining estrogen levels
• Estrogen-mediated gynecological cancers that can be worsened by HRT

So, there seems to be a “damned if we do, damned if we don’t” choice here, when it comes to HRT.

But, it’s not really. This is because of several factors:

Firstly, the cancer risk increase has been greatly overstated by a faulty study that has since been refuted but the press ran with it at the time and now that PR hit can’t be undone.

You can read more about that here: Cancer & HRT: What’s Safe?

Secondly, know that the cancer risk is mainly if you already have an increased cancer risk (e.g. current or previous cancer, or family history of that cancer, or you know you have a gene that increases risk of that cancer)

For more on that, see: The Real Benefit Of Genetic Testing

Thirdly, there is often some cognitive bias at hand in this matter: while people are typically more afraid of cancer (it’s a death sentence, right?) than breaking a bone (it fixes itself, right?) the truth is that after a certain age, a small increase in cancer risk is mathematically preferable in terms of health-related quality of life and survivorship/mortality, compared to a large increase in fracture risk, when in later a life such a fracture is typically life-changingly bad, and many go to hospital, get some infection, and die. Or otherwise simply never really recover, and everything is rapidly downhill from there. Whereas cancer? Your body killed cancer just now. Like it does every day.

Now, that’s not to say that cancer should be underestimated—it’s a serious problem and does kill many people. But in the cold hard light of day (and mathematics), it’s still better to take a tiny increase in cancer risk over a huge increase in fracture risk.

There are some ways around this conundrum

We have previously written, for example, about:

The Hormone Therapy That Reduces Breast Cancer Risk & More

Most recently, however, there’s a new way of doing things that’s been developed.

How it works: the estrogen is encapsulated in a two-layer shell that delivers it only to osteoporotic bone, avoiding systemic absorption to uterine (and other) tissues. By this we mean: it is assumed that this would also apply just the same to not being absorbed to the ovaries, breasts, and other tissues, but the study itself was looking at avoiding uterine/endometrial cancers specifically.

This matters, because postmenopausal estrogen loss accelerates bone resorption and weakens bone structure, but standard estradiol therapy can raise assorted gynecological cancer risks for some people, as discussed up top.

Note: we’re using “estrogen” and “estradiol” somewhat interchangeably here. To oversimplify it: estradiol is the most useful form of human estrogen, and it’s what modern estrogen therapy uses.

Now, when we say “encapsulated”, we’re not talking about capsules like you might commonly have when taking supplements. We’re talking microscopic here; the estrogen compound itself is encapsulated, with a covering that will only remove itself when it comes into contact with osteoporotic bone. In other words, it’s “special delivery” estrogen that can only arrive to one particular body structure, and not any others (it’ll just bounce off others without being absorbed, until, circulating in the bloodstream, it at some point reaches its bone target).

How that works: they coated estradiol with bone-seeking peptides that bind calcium, then enclosed it in tannic-acid–magnesium cages that stay intact in neutral pH but dissolve in acidic bone-loss microenvironments.

As a bonus, this also has a dual therapeutic action: tannic acid blocks bone-dissolving cells, and magnesium ions support bone-forming cells, while (as mentioned above) the estradiol activates only when the shell breaks down

In terms of testing, we’re not at human trials yet, hopefully soon, but here’s what there’s been so far:

• In vitro: coatings remained stable in bloodstream-like pH but reliably released contents in acidic solutions that mimic osteoporotic bone
• Mouse studies: twice-weekly injections of the encapsulated hormone for four weeks raised bone density above pre-osteoporosis levels with no uterine side effects and showed fluorescence-verified localization only in weakened bones

You can find the paper itself, here:

A Metal–Phenolic Network-Coated Coacervate System Mediates Mitochondrial Modulation and Bone Homeostasis Restoration for Postmenopausal Osteoporosis Therapy

Want to learn more?

If osteoporosis (or risk thereof) is a concern for you, you might want to check out:

• The Bare-Bones Truth About Osteoporosis
• Osteoporosis & Exercises: Which To Do (And Which To Avoid)
• Which Osteoporosis Medication, If Any, Is Right For You?

And for a much deeper dive into avoiding osteoporosis, cancer, and more, check out:

Unbreakable: A Woman’s Guide to Aging with Power – by Dr. Vonda Wright

Take care!