Women’s Wellness: A Word About Bone Health

The best way to get enough calcium each day is to eat a variety of healthy foods.

Osteoporosis and osteopenia are both diseases in which bone density is low. The conditions are associated with an increased risk of bone fracture. Osteoporosis is commonly seen in postmenopausal women. In osteopenia, bone density is lower than normal but does not meet criteria for osteoporosis. While both men and women can have bone loss, there are multiple reasons why women are more likely to get osteoporosis than men, including:

• Women tend to have smaller, thinner bones than men.
• Women often live longer than men. Bone loss happens naturally as we age.
• Estrogen, which helps maintain bone density, decreases when women reach menopause, which can lead to bone loss.

Are Some Women More at Risk for Osteoporosis?

The risk for osteoporosis is higher if you:

• Have entered menopause - After menopause, your ovaries make very little estrogen, a hormone that helps protect bone density.
• Have a family history of osteoporosis.
• Do not get enough calcium and vitamin D - Both calcium and vitamin D help to build and maintain strong bones.
• Do not get enough physical activity - Regular weight-bearing physical activity, like walking, needs to be done regularly by women of all ages to help build and maintain bone density.
• Smoke - Women who smoke have lower bone density and often go through menopause earlier than nonsmokers.
• Have a health problem that raises your risk of getting osteoporosis - Diabetes, celiac disease, premature ovarian failure, depression, and inflammatory bowel disease can raise the risk.
• Drink too much alcohol - Heavy drinking can cause health problems that include bone loss, heart disease and stroke.
• Have an eating disorder - Eating disorders – especially anorexia nervosa and bulimia nervosa – can weaken bones. Also, being underweight increases the risk of bone loss and fractures.
• Have a small body frame - People with small, thin body frames tend to be at higher risk of fractures because their bones tend to be thinner. As bone density decreases, thin bones break more easily than thick bones.

Even though the risk is higher for women, men can still develop osteoporosis, although it usually develops later in life. By age 70, men catch up to women in the rate at which they lose bone.

Signs and Symptoms of Osteoporosis

Typically, there are no symptoms in the early stages of bone loss. Once the bones have been weakened by osteoporosis, you might have signs and symptoms that include:

• Loss of height
• A stooped posture
• A bone that breaks more easily than expected
• Back pain

How Much Calcium Does an Adult Need?

The amount of calcium needed for healthy teeth and bones is different by age:

• Adults 19-50 years: 1,000 mg
• Adult women 51-70 years: 1,200 mg
• All adults 71 years and older: 1,200 mg
• Pregnant and breastfeeding teens: 1,300 mg
• Pregnant and breastfeeding adults: 1,000 mg

The best way to get enough calcium each day is to eat a variety of healthy foods. Getting enough Vitamin D every day is important to help the body absorb and use calcium from food. These are some options for foods high in calcium:

• Dairy products like milk, yogurt and cheese have the highest calcium content.
• Dark green, leafy vegetables contain high amounts of calcium. Collards, kale and broccoli are good sources.
• Sardines or canned salmon are loaded with calcium.

Does Vitamin D Help Prevent Osteoporosis?

Vitamin D plays an important role in your body. It keeps your bones strong by helping your body absorb calcium and phosphorus. Your muscles need vitamin D for movement and your nerves need it to carry messages throughout your body. The recommended amount you need each day depends on your age:

• Women up to age 70: 600 international units (IU)
• Women 71 and older: 800 IU
• Pregnant and breastfeeding women: 600 IU

How Can You Get Vitamin D?

Your skin makes vitamin D when it is exposed to sunlight. Generally, you need 10 to 15 minutes of sunlight to the hands, arms and face, two to three times a week. The amount of time you need to spend in the sunlight also depends on the sensitivity of your skin to sun, how much skin is exposed to the sun, your skin color, the season, the latitude of where you live and your use of sunscreen.

You can also get vitamin D from foods. Some foods have it naturally, like:

• Salmon, tuna, and mackerel
• Beef liver, cheese, and egg yolks

Some other foods that are fortified with vitamin D include:

• Milk
• Some orange juice, yogurt, and soy drinks
• Breakfast cereal

Overall, it is best to get vitamin D from sunlight and food, but you can also get it in a supplement. Many calcium supplements include vitamin D. Be careful how much sun exposure you get as it can damage your skin. Studies have shown a history of sunburn is linked to skin cancer.

Physical Activity is Important

Regular physical activity of any type can help slow bone loss, help with balance, and improve muscle strength. Weight-bearing physical activity is especially vital to build bone and help prevent bone loss. Any activity where your body works against gravity is known as weight-bearing physical activity.

Some weight-bearing activities you can try:

• Dancing
• Lifting weights
• Tennis
• Yoga
• Running
• Walking
• Gardening

Treatment of Osteoporosis

Osteoporosis treatment may involve medication along with lifestyle changes. Bisphosphonates are usually the first line of treatment. These include:

• Alendronate (Fosamax), a weekly pill
• Risedronate (Actonel), a weekly or monthly pill
• Ibandronate (Boniva), a monthly pill or quarterly intravenous (IV) infusion
• Zoledronic (Reclast), an annual IV infusion

St. Mary’s provides IV medications at our Ambulatory Infusion Center on Atlanta Highway.

How Can St. Mary’s Help?

St. Mary’s Wellness Center provides a fully equipped fitness gym, massage therapy, personal training, and cardiopulmonary rehab. The Wellness Center offers a wide range of fitness classes to help you feel good about getting in shape or recovering after an injury, illness or surgery. The gym features equipment like treadmills, stationary bikes, rowing machines, strength training machines, free weights, and more.

St. Mary’s also offers fast, convenient outpatient radiology services including bone density testing at our Outpatient Diagnostic, Rehab & Wellness Center at The Exchange.

It is important to talk with your primary care physician about your individual risk factors and preventive measures that are right for you. They can also refer you to a specialist, if needed. St. Mary’s Endocrinology specializes in seeing patients with a variety of conditions including osteoporosis and metabolic bone disease.