Statistics indicate that around 70% of American women will face either osteopenia or osteoporosis in their lives, with these bone conditions being particularly prevalent among women, especially during and after menopause.
Dr. Jocelyn Wittstein, an orthopedic surgeon at Duke University, emphasizes the importance of recognizing these risks earlier than many women do.
“A major issue is that many don’t think about their bone health until later in life,” Wittstein stated, “often after experiencing a fracture.”
Such fractures can signify weak bones, a condition known as osteopenia, which can advance to the more severe osteoporosis.
“It’s a silent disease until, suddenly, it’s not,” Wittstein remarked. Women may not realize their bones are weakening as they age, but this deterioration accelerates as they approach menopause.
This brings us to a key question: How can we safeguard our bones and either prevent or slow the decline in bone density?
Here are some insights from Wittstein:
Don’t hesitate to get a DEXA scan
DEXA scans, or Dual-Energy X-ray Absorptiometry scans, assess bone mineral density with a “T-score” that compares an individual’s bone density to that of a healthy 30-year-old. These scans are crucial for detecting both osteopenia and osteoporosis.
The T-score is telling. A normal range is between 0 and -1. If you fall between -1 and -2.5, that indicates osteopenia, while a score worse than -2.5 designates osteoporosis, according to Wittstein.
I personally had a DEXA scan last year which resulted in a T-score of 0.1. According to Wittstein, my bone density is normal with a low fracture risk. The scan itself was quite straightforward and took only about 15 minutes.
Identifying weak bones early is vital to halting the progression of osteopenia before it escalates into osteoporosis.
However, Wittstein feels that many women are waiting too long to get their first DEXA scan. From her observations, women typically don’t receive a scan until they are around 65 years old. She suggests that scans should ideally begin around the average age of 50 or 51, during the transition into menopause.
“It’s particularly crucial during the menopause transition,” Wittstein advised, as that’s when women should start asking for DEXA scans.
Diet and exercise are your first lines of defense
Wittstein encourages women to enhance their bone health by incorporating strength training and impact exercises into their routines.
Why focus on these activities, like jumping jacks or squat jumps? Because they prompt the body to build denser, stronger bones.
Having robust bones boosts balance, which significantly lowers the risk of falls and fractures. A fracture may not appear severe for women under 65, but it’s alarming that about 30% of those who break a hip could die within one to two years, Wittstein warned.
Strength training can contribute to keeping women steady on their feet, thereby minimizing the chance of fractures from falls.
You don’t need to be a gym expert to benefit from this advice. Regardless of fitness level, adapting movements to fit your capacity is vital. Wittstein suggests finding a manageable entry point and gradually increasing intensity as your body gets stronger.
“Any movement is better than none,” she mentioned.
Ensure you get enough micronutrients, like calcium and vitamin D
Your diet also plays a crucial role in maintaining bone health.
While calcium is often highlighted as essential for bones, Wittstein reminds us that it’s not the only nutrient to consider. A range of micronutrients work together to strengthen our bones.
Vitamin D, often underestimated, is vital because it aids in the absorption of calcium, making it more effective at fortifying bones. Natural sources of vitamin D include fatty fish like salmon, eggs, and of course, sunlight.
Additionally, magnesium and vitamin K are important for bone health. Wittstein explained, “Magnesium activates vitamin D, which helps absorb calcium from our diet, while vitamin K directs it to the bones for mineralization.”
Fiber is also significant due to its anti-inflammatory properties, so a diet rich in fruits and vegetables is crucial for bone health.
Wittstein recommends taking 600-800 units of vitamin D daily if deficient, along with 1,000 milligrams of calcium and 300-400 milligrams of magnesium as part of a routine to support bones.
Always check with your primary care doctor to better understand your specific needs regarding vitamins and minerals.
Consider hormone therapy to reduce bone density loss
Menopausal hormone therapy (HRT) is primarily prescribed for menopause symptoms, but research suggests it can offer additional advantages. Not all women should consider HRT, and it’s important to discuss any changes to your health plan with a doctor.
Over time, women experience significant variations in bone density, particularly around menopause. By the time women reach their 30s, they have typically achieved 90% of their bone density, followed by a gradual decline. However, about two years prior to menopause, there’s often a rapid loss of bone density.
“You could lose roughly 10% in that short time frame,” she stated.
Estrogen is instrumental in maintaining bone strength. Wittstein explained, “Estrogen inhibits the breakdown of bone.” During perimenopause and menopause, fluctuations in estrogen can lead to osteopenia, which is a precursor to osteoporosis.
Because bone density loss can trigger inflammation, and since “estrogen has anti-inflammatory properties,” the added support from HRT during menopause may help slow the onset of bone diseases, she added.
Menopausal hormone therapy could be beneficial in mitigating bone density loss by helping to regulate estrogen levels. Wittstein is optimistic about HRT’s future role in managing this issue, noting that one “FDA indication for hormone therapy is bone protection,” in addition to treating common menopause symptoms like hot flashes and night sweats.
Currently, there’s no standalone cure for bone diseases, so women need to be proactive in their health decisions—especially concerning conditions like osteopenia and osteoporosis that impact many of us.
Wittstein concludes with a focus on “exercise, maintaining a healthy diet, and possibly considering hormone therapy” as proactive measures women can take for their overall health throughout their lives.
Even with challenges like osteopenia, making these choices can slow progression. As Wittstein reassures, “you can still live a very full life.”
