Though chemotherapy had pushed her into menopause in her late 30s, Virginia had never taken estrogen, dismissing it as “unnatural. ” She’s been generally healthy in the twenty years since, taking antioxidants and calcium and magnesium supplements (though not getting much in her diet), walking to and from work every day, eating well, and never smoking. Still, as she approached 60,1 recommended she have her bone density checked, since early menopause, chemotherapy, and no HRT were all risk factors. Although she had no symptoms and hadn’t lost any height, a bone scan showed her spinal bone density was almost 25 percent lower than ideal (though just about what was expected for her age), and her hip was almost 35 percent lower than it would have been at its peak (and close to 20 percent lower than what you would expect at her age). Her NTX level was also relatively high, meaning she needed to take immediate action to avoid a fracture.

Other lab tests pointed out that even with the supplements Virginia took, she wasn’t getting enough for her bones, so she increased her dose and backed it up with a range of other nutrients similar to the plan described in Chapter 10. The only change she made in her diet, which was already basically good, was to add more servings of calcium-rich food, which she had been lacking. Her feelings about prescription HRT hadn’t changed any, but natural progesterone cream appealed to her, so she started on it right away. She took up some more structured exercise in addition to her daily commute/walk. She decided on strength training focusing on her upper body since it is the lower body that gets more of the impact (and so bone density benefit) of walking.

Virginia’s been on the progesterone for a year now, reports no side effects, and says she feels good overall. Her NTX has dropped and in another year a new bone scan should show if her progress has been sufficient to stick with the course, but I’m confident she’s stopped losing bone mass and that her body is building some back up.

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