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Hormones and Healthy Bones

National Osteoporosis Foundation Many Americans do not typically think about the health of their bones in the same way as they might consider other body systems. Yet, healthy bones are a vital component of overall health. Unhealthy bones can easily fracture, leading to disability, immobility, and related negative health outcomes. With a better understanding of how to maintain bone health, including the impact of hormones, healthcare providers and their patients can work together to reduce the risk of osteoporosis and ensure healthy bones throughout their lifespan.

The Association for Reproductive Health Professionals (ARHP) and the National Osteoporosis Foundation (NOF) have developed a professional education project to inform healthcare providers in the United States about the role and proper usage of hormones in order to make appropriate recommendations to their patients regarding hormones (both natural and synthetic) and their impact on overall bone health.

ARHP can arrange speakers to present on a variety of reproductive health topics at clinical conferences or grand rounds. Click here to learn about the available topics and programs.

For more information, please contact ARHP at education@arhp.org, (202) 466-3825) or NOF Senior Director of Education, Susan Randall, RN, MSN, FNP-BC (susanr@nof.org, (202) 721-6343).

Background

According to the U.S. Surgeon General’s 2004 Report, Bone Health and Osteoporosis, osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older. Of those individuals affected by osteoporosis, 80 percent are postmenopausal women.  However, osteoporosis is a significant health threat to more than 2 million men in the United States as well.

Maintaining strong, healthy bones is important for overall health. If left undetected and untreated, osteoporosis can lead to disability, immobility, and a host of negative outcomes including high healthcare costs and early death. As the role of reproductive hormones in osteoporosis becomes better understood, health professionals will need guidance on how to discuss bone health with their patients in terms of contraception, menopause, and andropause.

In men, sex steroid levels gradually decline with age, which can contribute to bone loss.  Both androgens and estrogens appear to be important for bone health in men.  Approximately 50 – 60 percent of men with osteoporosis have disorders or conditions that can produce bone loss, including hypogonadism, hyperthyroidism, intestinal disorders, malignancies, steroid therapy, and organ transplantation.

Program Design and Educational Activities

The Hormones and Healthy Bones program includes many carefully developed components to meet health care providers’ needs for education. All program components were established based on the results of comprehensive needs assessment and expert clinical opinion. Program components include:
  • To launch the Hormones and Healthy Bones partnership, NOF and ARHP convened a meeting of experts to address key issues surrounding hormones and bone health through case study discussions. The meeting held on February 28th, 2009 in ARHP’s Washington, DC, office and its discussion informed the development of other program components. A summary of the meeting case studies, discussion, and next steps are available here.
    • To augment the case study discussions, NOF and ARHP compiled and provided to experts attending the meeting comprehensive literature reviews on clinical issues related to natural and synthetic hormones and bone health.
  • PowerPoint slide modules with talking points in a case study format, focusing on clinical issues related to natural and synthetic hormones and bone health
  • Integration of content into the Curricula Organizer for Reproductive Health Education (CORE), ARHP’s online, open access collection of peer-reviewed, evidence-based teaching materials
  • Live educational session at Reproductive Health 2009, the annual meeting hosted by ARHP, Planned Parenthood® Federation of America, and the Society of Family Planning
  • One live and one archived webinar session
  • Hormones and Healthy Bones brochure which helps midlife women make better choices for a healthy future

Curriculum Learning Objectives

At the conclusion of this activity, participants should be able to:

  • Identify two hormone-related conditions that affect bone health in your patients in order to inform an appropriate treatment plan
  • Critically evaluate three tools/tests used to accurately assess fracture risk in your patients
  • Use three interventions to support bone health, as measured by the absence of fractures in your patients
  • Apply pertinent recommendations for hormone therapy in your patients, so that quality of life is improved

Intended Audience and Accreditation

The professional education component of this project is intended for healthcare providers in family practice, obstetrics and gynecology and internal medicine.  This includes physicians, nurse practitioners, nurse midwives, registered nurses, pharmacists, physician assistants, densitometrists, rehabilitation professionals, fitness professionals, public health professionals, and health educators. The live session and Webinars associated with this program are accredited for continuing medical education, nursing contact hours, pharmacology, and pharmacist credits.

This project also addresses the consumer audience through media outreach, patient education materials, and general health education resources.

Funding

This project is funded through an independent educational grant from Wyeth Pharmaceuticals.