Dr. Mary Claire Haver

So the bone turnover marker is as we're chewing up bone and laying down bone, there's little chemicals that get excreted into the blood.

So we can say, oh, she's going through a lot of bone turnover and bone loss.

So that's a way to kind of measure how these medications are working without having to wait two years for a bone density scan.

And there's in my world, in the menopause society and in the OB literature, they're very hesitant.

They do not want to measure estradiol levels.

They're like, no, we treat hot flashes.

You give her enough estrogen to treat a hot flash.

But my bone people are like, hmm,

Just because you're protecting her from hot flashes does not mean her bones are necessarily protected.

And I think maybe... They're very keen on dose.

You mean estradiol level of 20?

So that's how we define menopause to our listeners is an estradiol level less than 20, pretty much postmenopausal.

There's some nuance.

Yeah.

Not much of a difference.

And in our clinic, and most of my, you know, the menopause-y kind of people, we don't sit here and slap an estrogen patch on someone and be like, go and live.

You know, it's like, if you want to protect your bones, you have to do all the things, which includes the lifestyle.

And if you are not...

doing the lifestyle changes, including diet, including nutrition and lowering inflammation and all the things, you are not, this is probably not likely going to have, you know, not the greatest effect.

In our clinic, we talk about lifestyle as well as HRT and, of course, some of the other drugs, the bisphosphonates, you know, if they're already diagnosed.