Does a Barren Woman Have an Increased Risk of Osteoporosis?
By Ken Hutchins and Brenda Hutchins
Recently, a woman asked us questions related to this issue, and we see the need to present the following correlations and our opinions about them. Please don’t take our opinions as fact but use them to question your doctors if the need arises and to accept what you find online with skepticism.
This subject is cumbersome to manage. To simplify its discussion somewhat, we number the major statements (sometimes correlations) to be compared. Example: #1, #2, etc.
Please comment if you have insights or disagreements to any of our statements herein. We need more clarity, and we intend to massage this article to make corrections over time as we adjust to new information.
We believe that we first encountered the following correlation (#1) during our supervisory stint at the Nautilus-funded osteoporosis research project (1982-1986). We have heard it repeated only once or twice since then. However, we suspect that it is widely proffered by doctors to their female patients:
#1 A woman not having children increases her risk for osteoporosis.
As much of the research supports #1 (and we agree with it in cases wherein adequate nutrition is consumed, conditional that progesterone supplementation is not available), we regard its following common misinterpretation and intellectual rendering (#2) to be highly suspect:
#2 A woman electing not to have children increases her risk for osteoporosis.
Here, the key word is electing. Please deliberately note that this word is implied in statement #1. And the implication—intended or not—is what the patient hears (her mind’s ear) and embraces. She may dwell on her choice in the matter. And we believe that the issue of a woman’s choice to become pregnant is grossly overlooked in the research regarding osteoporosis risk and its association with non-gravidity/ nulliparity.
It is also important to note that this implied emphasis on electing seizes the mind of the medical personnel who state #1. It is not just the audience targeted with #1, but often also the verbal source of #1 that succumbs to this subtle intellectual capture.
The question (as borne in the title of this post) “Does a barren woman have an increased risk of osteoporosis?” begs another important, but almost always skirted question:
Why would a woman be barren?
This WHY is central to justifying the recommendation of pregnancy in osteoporosis prevention.
The following research paper (Nulliparity and Fracture Risk in Older Women: The Study of Osteoporotic Fractures) from 2003, overwhelmingly suggests that pregnancy fosters protection against osteoporosis. We conditionally concur with its overall assessment.
https://onlinelibrary.wiley.com/doi/pdf/10.1359/jbmr.2003.18.5.893
But buried within its 1,354-word Discussion* is this sentence providing a hint to what we’re about to expose:
[#3] Furthermore, some nulliparous women could be subfertile [our emphasis] with reduced estrogen production during the menstrual cycle and thus might be at risk for fracture…
Precisely, what is subfertile? Were the authors of this paper merely too lazy or hurried to contemplate the far-reaching and issue-packed nuances of this word?
[*Sadly, this Discussion highlights the variation in estrogen and makes no mention of progesterone! Nor is progesterone mentioned anywhere in this entire 5,827-word research paper, including the Acknowledgements. But, excluding the Acknowledgements, estrogen is mentioned 13 times.
John Lee, MD, as best as we can estimate, met Ray Peat in 1971 and learned:
We had all been taught that menopause (when the ovaries stopped making their hormones) led to a variety of female complaints that represented estrogen deficiency. We had believed it obvious to treat such patients with estrogen. Yet here was a PHD in biochemistry telling us we were wrong.
As Lee wrote this in 1979 and largely focused his book from which this quote originates (What Your Doctor May Not Tell You About Menopause) on osteoporosis, this information was widely available before this 2003 research paper was published.
Peat published his book (Progesterone in Orthomolecular Medicine) in 1993.
This explains our conditionality for accepting the apparent wisdom of this research paper and many similar others. As both Peat and Lee promoted, estrogen dominance is the problem with many women’s health issues and estrogen supplementation exacerbates this dominance. The answer to the estrogen dominance is progesterone supplementation, and with progesterone supplementation, the supposed benefits of repeated pregnancies goes away!
The highlighted 2003 paper has merit only in the absence of progesterone supplementation and, to repeat, within the context of good nutrition.
If you have not already, please read the following article for more information about progesterone. Be sure to study the comments:
https://ken5.substack.com/p/the-scourge-of-the-bone-drugs ]
Does subfertile mean a lack of ova or a failure to ovulate? We suppose that these are two separate concerns. We suppose that a woman might possess ova, but not ovulate.
Does subfertile mean not fertilized as with the ovum meeting a sperm (conception)?
[Example: Ken’s mother had 11 pregnancies, eight to viable babies. Hence, she was highly fertile in almost every sense of the word. But for a while, she could not achieve pregnancy due to a cervical stenosis. As the first born, Ken was conceived by his father injecting his sperm from a 50cc syringe connected to a Robinson catheter that was threaded through her cervix and into her uterus. Without these applied mechanics (used on farm animals for centuries), conception was impossible.]
[Although we must admit that a case study cannot serve as a generalized correlation, we again use Ken’s mother as an exception to what is supported in the previously linked study and many other studies.
At 68, she incurred an osteoporotic hip fracture. As this event was not prevented, was it at least delayed due to her high gravidity? Was this event partially accelerated due to her leanness? (We discuss the relationship of fat and estrogen later.) She lived another 25 years.
Ken’s father praised her for always quickly regaining her slim figure after each of her pregnancies as he observed that many women become progressively fatter with each of their subsequent pregnancies.]
Nothing in statement #2 suggests that there is often no choice on the part of a woman for becoming pregnant. There are many unwanted and accidental pregnancies. There are women who conceive as a result of rape. And there are women who cannot attract a mate or who might be marooned on an island where there is no man. There are women with a hormone imbalance that prevents either pregnancy and/or parity. There are women who are incarcerated and denied copulation. And there are women who ovulate and might fertilize with perfect implantation but who have a cervical stenosis thus preventing conception. Therefore, we introduce another statement:
#3 Women are often barren through no choice of their own.
Assuming that there is a strong correlation (statement #1) BETWEEN a barren (nulliparous and/or non-gravidity) woman AND her possessing an increased osteoporosis risk, such a correlation cannot approach the essence of a cause-effect relationship if statement #2 is the real intent of meaning. The essence of statement #2—choice—collapses the possibility of a cause-effect relationship and makes for a very weak correlation; however #1 (on its face) remains a strong conditional correlation.
There are other correlations ongoing in parallel with #1.
Another correlation is:
#4 Women with certain hormonal imbalances are unable to achieve pregnancy or to carry to term.
Another correlation is:
#5 Women with hormonal imbalances figure heavily into osteoporosis.
If we were to dig into the research that purports to push correlation #1 toward its implied rendering (#2) (and then pushing this idea as a cause-effect relationship), our priority would be to establish if the authors of such studies attempted to ascertain if these barren women were purposefully (by choice) barren OR if they had imposed barrenness. In other words, were they barren because they decisively and deliberately chose not be a parent OR were they barren because nature had deprived them of a progenitory hormone balance or because of some other obstacle to conception?
In essence, either statement (#1 or #2)—stated nakedly—conceals the issue about a woman EITHER being unable OR being unwilling to have children. And the available research does not and probably cannot distinguish these two groups of vaguely but crucially distinct women subjects. These are two separate cohorts that are critical (for establishing a cause-effect) to distinguish and that are necessarily (probably) and blindly (probably) scrambled into the same cohort.
Herein and thus far, we have linked only one research paper. It adequately serves our purpose to draw out the issue of choice. We don’t expect to find or ever see that choice is parsed with separate cohorts. Again, we doubt that this is possible.
Note that in their discussion, the researchers did, indeed and to their credit, at least mention the choice issue, although as we have opined, nothing about it can be evaluated.
Finally, we are unable to assess if nulliparity was because of choice or inability to conceive in some women, and the nulliparity effect may be greater in those women with infertility.
Note the last phrase, “… and the nulliparity effect may be greater in those women with infertility.” In essence, the researchers admit the possibility that many women have no choice in the matter at all.
Linguistics
Although this meandering and unwieldy discussion pits our minds against the inconsistencies of our thinking about this subject, let’s not completely lose sight of the fact that the fundamental flaw at work here is the language… or in this case the lack of language and the predicate of thought from which to bridge.
Other Possibilities
Can Hormones Affect the Desire to Conceive? We see another potential factor related to the correlations expressed in statements #1 and #2. Is it possible that hormone imbalances cause a woman to be undesirous of children? Hormone imbalances certainly cause a host of emotional and physical abnormalities in women as well as in men. And normal aging, with attending hormonal changes, alters the priorities for children.
Does hormone balance affect choice (if choice is to be had)? Can correcting hormone imbalance yield a change of choice?
Postpartum depression is a common malady of women caused by a precipitous drop in progesterone. And the simplest, most effective, safest, and least expensive treatment is progesterone supplementation, NOT the common stock treatment with SSRIs.
Obviously, these are complex issues that are not likely to be isolated for objective study.
Fat Wedded to Estrogen? We were taught that estrogen loves fat and that fat loves estrogen. And we were also schooled that as many women age, they, like men, become fatter… and that both produce more estrogen (not more progesterone) as they grow fatter and older. [The men are feminized.] And conversely, when women are amidst a famine, they lose fat, and the attending estrogen becomes so diminished that their ovulation and menstruation is curtailed (even before menopause).
Additionally, we were schooled that many older and overfat menopausal women produce more estrogen from their subcutaneous fat stores than a young, menstruating woman with fully functioning ovaries. How does all this figure into a doctor’s advice to a young woman about her risk of osteoporosis if she does or does not produce children? We find this all contradictory and confusing, especially when progesterone is often the real deficiency to be supplemented, not so much the estrogen [There are exceptions].
Therefore, when a doctor advises that avoiding pregnancy increases osteoporosis risk, make that doctor demonstrate an awareness for all of these correlations, especially to include the ignored issue of choice in the research. Then put him on the spot about progesterone!
The Countervailing Argument
It’s important for Brenda and I to acknowledge that, although our current [conditional] belief is that pregnancy lends protection (not prevention—another distinction to parse) against osteoporosis, our long-time stance was that pregnancy increased osteoporosis risk (and it does within the context of poor nutrition). And women need to know both sides of the argument, not just the prevailing one.
Pregnancy and nursing leach calcium from a woman’s bones. Calcium is consumed by all stages of early child development be it zygote, embryo, fetus, or nursing baby. And calcium cannot be inhaled or dermally acquired. It must be consumed through the diet.
Assuming that dietary calcium and/or starting bone mass and density is adequate to prevent catastrophic failure of the skeleton, the skeleton is the woman’s calcium reservoir. The calcium ebbs (during pregnancies and nursing) and surges (between pregnancies and nursing) above a minimum threshold of healthy maintenance. Without adequate calcium replacement and the hormones (especially progesterone) and vitamins (D3 and K2) to offset leaching, the skeleton fails. If a pregnant woman exists long enough in an environment of poor diet, the osteopenia may take her down before she expires due to other factors.
Medical Terrorism?
Is it possible that the advice—directly or indirectly, overtly or covertly—to have children as an osteoporosis preventive is, to some degree, medical terrorism? Brenda and I have both encountered judgmental lectures from doctors who were disapproving of our decision to avoid spawning children. It was as if we had no right to make these personal choices.
We slightly suspect that statements #1 and #2 are colored with some conspiracy to serve as grist for profit by the medical community. Did the doctors expect us to build their practices for them? Of course, our readership is familiar with our ingrained distrust of the medical establishment.
Also, Brenda has experience with gynecologists recommending pregnancy to cure issues like endometriosis. And once we learned that many of these issues were remedied by progesterone supplementation, we can appreciate that the rise of progesterone levels during pregnancy explains the outdated pregnancy recommendation.
As we have attempted to underscore, the argument to use pregnancy as a deterrent to osteoporosis is possibly valid in the absence of progesterone supplementation (and within the context of adequate Calcium consumption). With adequate progesterone supplementation, this argument is medical bullshit. The issue of pregnancy has no basis at all—or at least should not have.
It’s bullshit that doctors don’t know of Peat’s biochemical revelations. It’s bullshit that doctors don’t know of Lee’s practical clinical applications. It’s bullshit that doctors don’t know the difference between progestins and progesterone. And it’s bullshit that doctors don’t know about Time-Static Contraction exercise that could be accessed by their patients with little or no equipment. The doctors are wallowing in bullshit.
The obvious reason that progesterone is not widely deployed by the medical community is that it is dirt cheap. Progesterone cannot be patented as it is a natural substance. Thus, Big Pharma directs doctors away from it, ignores it, and refuses to research it.
We lay responsibility for this medical atrocity most firmly at the feet of the gynecologists. For sure, they are the front-line attendants of women’s health, not that this issue is exclusively a female issue. [Men also suffer from estrogen dominance.] And progesterone supplementation is a great boon to the treatment of many medical issues (an incomplete list):
osteoporosis
vaginal dryness
endometriosis
hot flash
uterine fibroids
cervical dysplasia
fertility
fibrocystic breasts
depression (especially postpartum depression)
cyclical migraines
sleep disturbances
thyroid dysfunction
blood clotting issues
libido abnormality
endometrial cancer
breast cancer
DCIS (ductile carcinoma in situ) (pseudo breast cancer)
prostate cancer (men)
gynecomastia (men)
autoimmune diseases
poor estrogen reception
digestive problems
With progesterone supplementation, many unnecessary surgeries can be avoided.
Although the problem has perhaps greatly improved in the past 20 years—since Ken’s last conversation about this with one of our esteemed internal medicine friends—we strongly doubt this. If we can use medicine, in general, as a gauge, we know that major facets of the medical delivery system have suffered a major loss of quality.
And there are doctors from the various other specialties that are culpable. Notably are the endocrinologists. Are they not supposed to be at the cutting edge of bio-medical chemistry?
For your protection from the doctors, you must know enough about all these factors to combat their bullshit. Your life and its quality depend upon it.
Further Reading (Links and Commentary Provided by Chris Highcock)
This notes that having children is protective for hip fractures
https://pubmed.ncbi.nlm.nih.gov/33548574/
And this article notes,
In fact, studies show that having children, even as many as 10, does not increase a woman’s chance of getting osteoporosis later in life. Research even suggests that each additional pregnancy provides some protection from osteoporosis and broken bones.
Ray Peat has a few articles noting the relation between estrogen and osteoporosis.
https://raypeat.com/articles/articles/estrogen-osteoporosis.shtml
If his thesis is correct then osteoporosis could be addressed by limiting prolonged exposure to high levels of estrogen.
I also found this
During pregnancy other hormones, especially progesterone, were also increased, and it was suggested that this reversed the effects of aging and estrogen. Since most people had believed that frequent pregnancies would cause a woman to age more rapidly, a large survey of records was done, to compare the longevity of women with the number of pregnancies. It was found, in the very extensive Hungarian records, that lifespan was increased in proportion to the number of pregnancies.
https://raypeat.com/articles/articles/osteoporosis-aging.shtml
Christ Almighty. What doesn't occur to both or either of you. I think I speak for many of us that we are grateful for your observational skills. Thanks for this.