Dr. Jocelyn Wittstein

There's a silent disease, which prevention of osteoporosis is and has been for a long time an FDA-approved indication of menopausal hormone therapy for protecting your bone density.

But the end result of declining estrogen levels and more bone resorption than bone building is this progression to osteoporosis, then fracture.

The end result is so far down the line,

that the people seeing at the end of the line were not there at the beginning of the process.

And so, again, it's this siloed approach.

And I'm on our, you know, fracture fragility committee, and I'm pushing really hard to get our distal radius fractures, you know, your wrist bone fractures, which peak for the first time in women between the age of 50 and 60.

I want that group to go to the fragility clinic.

The silver lining, if you fall and break your wrist, I mean, there's good and bad things to this.

If you're a 50-something-year-old woman and you fall, same level fall and break your wrist,

Depending on the study you read, you have a nearly 50% or maybe 200% greater risk of eventually breaking your hip as compared to a woman who never had a distal radius fracture.

But this group of people, if you had a distal radius fracture, you are the group I want to focus on because if I get you to a fragility fracture clinic and I get you a DEXA before the age of 65 and you're diagnosed with osteopenia,

And you make your hormone therapy decision about potentially bone health as the driving factor maybe.

And you're in the window where you can safely start.

You're in the window of opportunity because, again, these are happening in women in their 50s.

this would inform you and you may say, okay, I don't want to have a hip fracture.

I am at increased risk for a hip fracture.

Maybe you have osteopenia, not osteoporosis.

And we know that hormone therapy that includes estradiol will increase your bone density over time and protect you against fractures, you know, quite significantly.

So I think we need to shift our thought process towards obviously earlier prevention.

Yeah.