Dr. Jerilynn Prior reminds us that ovulation is necessary for our health. PERIOD. What many of us are not aware is that bone loss does not begin with menopause. It begins at menarche. And if young girls are placed on synthetic contraceptives for long periods of time (no pun intended) the road to bone loss has already been established. And will continue to deteriorate and progress to menopause.
That puts a different spin on the story – doesn’t it?
Jerilynn C. Prior BA, MD, FRCPC
Silent Ovulatory Disturbances and Bone Loss in Young Women
7 pm ET – 4 pm PT
Jerilynn C. Prior BA, MD, FRCPC, is the founder (2002) and Scientific Director of the Centre for Menstrual Cycle and Ovulation Research will be my esteemed guest this Wednesday night on Holy Hormones Honey The Greatest Story Never Told on The Liberty Beacon Media Project.
Earlier this summer, Dr. Prior who is also a long-standing member of the Society for Menstrual Cycle Research, sent an email out to the membership sharing a link to an article published in Epidemiologic Reviews entitled: Negative Spinal Bone Mineral Density Changes and Subclinical Ovulatory Disturbances – Prospective Data in Healthy Premenopausal Women With Regular Menstrual Cycles
The article according to Dr. Prior is based on 25 years of her research. Although it was published in 2013, it is, in light of the rising controversy over the safety and efficacy of synthetic hormones, even more important today. Especially in light of the new ACOG guidelines recommending that teen girls be put on synthetic hormone IUD’s, injections and implants as young as age 12. In fact, many girls have had this type of birth control forced on them without informed and/or parental consent. Thanks to a new law in the state of Washington. A new law that is probably coming to your state. Should we be concerned that our daughters may be candidates for bone loss as they mature?
According to Dr. Prior, the research “…shows that normal amounts of progesterone are needed during the normal menstrual cycle in order to prevent bone loss. Why? Because although the total estrogen levels in a regular menstrual cycle are normal, and we know that estrogen’s job in bone is to prevent bone loss (which it does), the decrease in estrogen levels from the midcycle estrogen peak to the next flow causes an increase in bone resorption (removing old bone).”
Dr Prior postualtes: “I believe that is why progesterone, that directly stimulates bone formation (through osteoblast receptors) is needed to prevent overall bone loss.”
A lay explanation of the paper, provided by Dr. Prior is below.
Here’s what the article shows:
It is a “meta-analysis” (collecting and quantitatively combining data) of prospective observational studies from all of the world’s English language scientific literature. A meta-analysis carries a lot of scientific weight.
CeMCOR found six studies in 436 women who had provided information over an average of two years each. The women’s ages spanned 14-47 and most women collected ovulation information on five or more cycles a year. In general menstrual cycles were clinically normal with regular, normal length cycles. Results showed that those women within each study with more versus fewer cycles having ovulatory disturbances showed more negative changes in bone. (Ovulatory disturbances mean without ovulation and with no progesterone production [=anovulation, no release of an egg] or with ovulation but too little progesterone [=short luteal phase cycles]. Bone change on average was a loss of -0.86 percent of spinal bone density each year.
Here’s why these data are important:
We previously believed that regular menstrual cycles always release an egg and that normal amounts of progesterone (that is only made after ovulation) are required to bring on menstrual flow. This study shows that disturbances of ovulation and progesterone production are not only common, they are clinically silent. Why? Because they are occurring within menstrual cycles that are regular, normal in length and that no woman or doctor would suspect of being a problem. Of course these silent ovulatory disturbances would be an unsuspected cause for women’s infertility (making up about 25% of all infertility worldwide).
We also have previously believed that women with regular menstrual cycles did not need to worry about their bone health—it was only those with far apart cycles (oligomenorrhea) or no menstrual flow for 3 or more months (amenorrhea) that should be concerned about bone loss. We also believed that bone loss for women normally only started in perimenopause or menopause.
By contrast, these results show that silent ovulatory disturbances cause bone loss in young women who should be gaining bone or maintaining it. Prospective population-based information in Canada shows that normally women have steady or increasing spinal bone density until ages 33-402. Although bone loss of one percent (-1%) a year may seem tiny, if it were to continue over the 30-40 years of menstruating life, at this rate women could easily lose the more than 25% of peak bone mass that is associated with osteoporosis and fracture in menopausal women. In fact, the only common reason for osteoporosis that is diagnosed within 10 years into menopause is the rare risk of having too low a peak bone mass (in <10% of all women).
Therefore, silent ovulatory disturbances may be the major cause for the costly and debilitating problem of “Postmenopausal Osteoporosis.”
CeMCOR’s has committed to developing an accurate, convenient and inexpensive test to detect these silent ovulatory disturbances occurring within regular cycles. We could prevent this bone loss if women (and their doctors) knew that they were at risk. Please contribute to this important effort: http://www.cemcor.ubc.ca/
(1) Li D, Hitchcock CL, Barr SI, Yu T, Prior JC. Negative spine bone mineral density changes and subclinical ovulatory disturbances – prospective data in health premenopausal women with regular menstrual cycles. Epidemiol Rev 2013.
(2) Berger C, Goltzman D, Langsetmo L et al. Peak bone mass from longitudinal data: implications for the prevalence, pathophysiology, and diagnosis of osteoporosis. J Bone Miner Res 2010;25:1948-1957.
Jerilynn C. Prior BA, MD, FRCPC
Jerilynn C. Prior BA, MD, FRCPC, ABIM, ABEM is a Professor of Endocrinology and Metabolism at the University of British Columbia in Vancouver, B.C. She has spent her career studying menstrual cycles and the effects of the cycle’s estrogen and progesterone hormones on women’s health. She is the founder (2002) and Scientific Director of the Centre for Menstrual Cycle and Ovulation Research (CeMCOR). CeMCOR is actively researching women’s health and has a very accessible, informative website that receives on average over 1,700 page views per day (www.cemcor.ca).
She is also Director of the BC Centre of the Canadian Multicentre Osteoporosis Study(CaMOS) that is studying osteoporosis, fractures and bone density and has followed over 9000 adult women and men across the country for over 16 years, plus about a 1000 youth ages 16-24 for two years.
Dr. Prior has studied women’s menstrual cycles, perimenopause and the causes for and treatment of osteoporosis. CeMCOR/Prior has shown that regular cycles (with enough estrogen) commonly do no produce sufficient progesterone (anovulation or short luteal phases). More versus fewer ovulatory disturbances within regular cycles are related to significant spinal bone loss in healthy women ages 20-45. She has shown in controlled trials that the ovarian hormone, progesterone, is effective treatment for menopausal hot flushes. She also documented in a 3-months trial that progesterone is safe for heart health. Dr. Prior is internationally known for her research showing that progesterone increases bone formation by stimulating osteoblasts.
More recently, she has documented that estrogen levels, besides being unpredictable, are significantly higher than normal in the perimenopause, the 3-10 years of changes before menopause. She is widely sought as a speaker for professional and lay audiences and is the author of the award-winning book Estrogen’s Storm Season: Stories of Perimenopause, an informative book about perimenopause told in story format. Estrogen’s Storm Season was a finalist in the 2006 Independent Publishers Book Awards for Health.
With Susan Baxter PhD, sociologist/medical journalist, Prior is author of Estrogen Errors – Why Progesterone Is Better For Women’s Health (2009). This book aims to inform women of the decades of presumption and prejudice behind estrogen-centric women’s health dogma. She has authored scientific papers numbering over 200 and holds 6 patents. She is an Honourary Alumna of the University of British Columbia Faculty of Medicine and was awarded its Distinguished Medical Research Lecturer Award (2002). She has numerous other honours including the Ann Voda Lifetime Achievement award of the Society for Menstrual Cycle Research.