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April 30, 2025 58 mins

When women think about the benefits of menopausal hormone therapy, things like hot flashes, insomnia and vaginal dryness come to mind. 
But for many women, bone health is, or should be, at the top of the list.  
In this episode, I speak with Dr. Risa Kagan about the role of estrogen, progesterone, and testosterone in bone health.

  • Definition of Low Bone Mass (Osteopenia) and Osteoporosis
  • The Difference Between a T score and a Z score
  •  FRAX- Fracture Risk Assessment Tool
  • When Bone Mass Peaks
  • How to Maximize Bone Health Before Menopause Hits
  • Role of Estrogen in Young Women
  • The Danger Zone- When Most Women Lose the Majority of Their Bone Mass
  • The Role of Birth Control Pills and Prevention of Bone Loss
  • If Exercise is Enough
  • The Relationship Between Hot Flashes and Osteoporosis
  • Bone Loss Post Menopause
  • Impact of Menopausal Estrogen Therapy on Bones
  • Taking Menopausal Hormone Therapy (MHT) in the Absence of Hot Flashes to Protect Bones
  • The Difference Between Bone Density and Bone Quality
  • When it is Appropriate to Take an Anabolic Agent
  • If the TYPE of Estrogen you take matters (Conjugated, Synthetic, Bioidentical)
  • What DOSE of Estrogen is Needed to Prevent Fractures
  • If it is Appropriate to Monitor Estradiol Blood Levels When Taking Transdermal MHT
  • The Target Estradiol Level for Bone Health
  • What Happens to Bone Density When MHT is Discontinued
  • If MHT Should Be Taken Forever
  • If Progestogens Plays a Role in Bone Health
  • The Role of Bazodoxifene (Duovee™) in Bone Health
  • The Role of TESTOSTERONE therapy in Bone Health
Another Podcast with Dr. Kagan: When Progesterone is a Problem

  Dr. Risa Kagan is a Clinical Professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of California San Francisco, and a consulting gynecologist with Sutter Health. Dr. Kagan has published over 100 scientific papers  on post menopause bone health and hormone therapy. 

Dr. Streicher is on SUBSTACK      DrStreicher.Substack.com
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Information on Dr. Streicher's COME AGAIN Podcast- Sexuality and Orgasm


Lauren Streicher MD, is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, the founding medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause, and a Senior Research Fellow of The Kinsey Institute, Indiana University. She is a certified menopause practitioner of The Menopause Society. She
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