The Facts About Women and Osteoporosis

Dr. George Lane, Sr.
Advanced Orthopedics

Osteoporosis is perceived as only a disease of older women, but men also experience bone thinning and weakness. Although osteoporosis affects both genders, this article will focus on how women can prevent it.

Osteoporosis is a progressive disease that causes bones to thin and become more brittle, making them more predisposed to breaking. The bone itself isn’t abnormal, nor has it accumulated any abnormal tissue. It’s only a reduction in the amount of normal tissue needed to strengthen the bones. The amount of normal tissue in your bones is described as bone density.

There are many tests available to measure bone density, but the most common one is called the DEXA scan (dual-energy X-ray absorptiometry). This non-invasive test uses two X-ray beams to estimate bone density in your hip and spine. It’s fast and uses low doses of radiation.

Bone-Strengthening Habits
The most important things a woman can do to prevent osteoporosis are to include adequate vitamin D and calcium in her diet, quit smoking, and maintain a routine of weight-bearing exercise.
Calcium often is mentioned as an important mineral, but without vitamin D, most of the calcium we ingest will leave our system without being absorbed into our bloodstream. Vitamin D also allows the calcium to move from our blood into bone.

Sources of vitamin D include processed milk and sunlight. Your skin produces vitamin D when exposed to sunlight. However, due to low dairy intake and well-deserved cautions against too much sun exposure, many Americans aren’t receiving enough vitamin D. Fortunately, you can find vitamin D in a multivitamin or a calcium supplement that also contains vitamin D. The recommended daily amount is 400 I.U.

Dietary calcium can be found in milk, yogurt, cheese (preferably low-fat dairy products), almonds, cooked broccoli, dark leafy vegetables such as spinach, fortified cereals, fortified orange juice, enriched bread products, and many other foods.

If you’re unable to achieve the daily recommendation of calcium through your diet, there are two types of supplements to choose from. The first is calcium carbonate (i.e. Tums), which is a very acceptable form of calcium. To achieve the maximum benefit, it should be taken with meals. The other is calcium citrate, a more expensive option. It can be taken on an empty stomach or with food.

Whichever type of calcium supplement you take, it’s most effective to take divided doses. Although it isn’t harmful to take more than 500 mg in one dose, your body can only absorb a certain amount at any one time. Therefore, several 500 mg doses are more effective than one 1500 mg dose. Here’s the recommended daily intake:
• Childhood: 400-800 mg.
• Puberty and adolescence: 1500 mg.
• Adulthood (men and women): 800 mg.
• Pregnancy and breastfeeding: 1500 mg.
• Women after menopause: 1500 mg.
• Men after age 65: 1500 mg.

Taking appropriate nutrients is just part of the picture. This decade-by-decade guide provides other suggestions to help prevent osteoporosis.

In Your 20s
This is the prime decade for building bone mass because young bones respond well to weight training and build bone much more quickly than at later ages. It’s also a good time for 20-something women to begin establishing healthy eating habits and supplementing with extra calcium as needed. Pregnancy puts extra demands on your body and increases your calcium requirements.

In Your 30s
At some point in this decade, bone begins to break down faster than you can build it. If you haven’t yet made a commitment to healthy eating and consistent exercise, now is the time to do it. For many women, the 30s are even busier than the 20s, but taking care of yourself now will pay dividends in the long run.

In Your 40s
Even if you’ve been diligent about exercise and nutrition, nature begins to take control of your bone density as you lose estrogen. Instead of building bone mass, your goal now is to maintain what you’ve got. If your joints start to ache when exercising, switch to lower-impact activities, but continue to focus on weight-bearing exercise. Although exercise won’t increase bone density at this age, exercise will increase your strength and stability—which ultimately can prevent falls that lead to bone fractures.

In Your 50s
Some studies estimate that women lose up to 30 percent of bone mass in the decade following menopause. There are several options to help slow the loss of bone density:
• Estrogen. A new class of drugs called selective estrogen receptor modulators (SERMS) appears to strengthen bone without increasing breast cancer risk. Low-dose estrogen is also a possibility.
• Calcitonin. This is a hormone naturally produced by the body to regulate bone formation. It’s been found to decrease spine fractures and increase bone density.
• Bisphosphonates. These include Fosamax and Actonel. It’s believed these medications slow bone loss and allow bone to build back up.
• Hyperparathyroid hormone. This drug, sold under the brand name Forteo, recently was approved by the FDA. Not only does it stop bone loss, but it also stimulates new bone formation.

Of course, each medication has its own possible side effects, but this list provides an overview of potential treatments for osteoporosis. Your physician can help you determine the best approach, based on your age and health. TPW