Bone is living tissue that grows and dies in a continual cycle. In a healthy person, the process is seamless, with osteoblasts forming a new matrix upon which the tissue is deposited, and osteoclasts breaking down old, damaged, and worn-out tissue so the osteoclasts can build new, healthier bone.
Up until you’re about 30, your body naturally builds more bone than it loses. After age 35, though, the osteoblasts can’t keep pace with the osteoclasts, causing a gradual loss of bone mass.
By the time you reach 50, doctors estimate that 50% of women and 25% of men have developed the bone-thinning disease osteoporosis, which can lead to spontaneous fractures, especially in the spine, wrists, and hips.
At Capital Women’s Care, our expert team of providers diagnoses and treats women at risk for developing osteoporosis. The group with the greatest risk are small white or Asian women who are postmenopausal.
Here, the team explains why that’s so and what we can do to help you through it.
Hormones, especially the sex hormone estrogen in women, are responsible for telling the osteoblasts to build new bone tissue. When you reach perimenopause and then menopause, your estrogen levels drop sharply, causing an array of problems from night sweats and hot flashes to decreased libido and vaginal atrophy.
Another problem is a large decrease in new bone tissue because estrogen isn’t telling the osteoblasts to create new tissue. The result is that a cross-section of your bone looks more like Swiss cheese than the normal honeycomb pattern. You can lose 25% of your bone density or more after you’ve reached menopause, and it decreases at a rate of about 1-2% per year.
In addition, treatments for prostate cancer in men that reduce testosterone levels, and treatments for breast cancer in women and men that reduce estrogen levels, can accelerate bone loss.
The gold standard for diagnosing osteoporosis or osteopenia, an early stage of the condition where building and dismantling rates are equal, is a bone density test. It’s an imaging test that uses low levels of X-rays to look at the density of bone tissue and the mineral content in your spine, wrist, and hip.
Called a DEXA scan, the test is completely noninvasive, takes about five minutes to do, and has no prep or downtime associated with it. The results are reported as T scores, numbers that compare your tissue to that of a healthy person of the same general age.
If you’ve gone through menopause, it’s a good idea to ask your doctor to give you a referral for the test if they don’t do it themselves in their office. Osteoporosis comes with no symptoms, and the first indication you have a problem may be when you break a bone after a fall or even just bending over or sneezing.
It’s especially important to get a DEXA scan if you’re postmenopausal and also have other risk factors like small stature, a family history of the condition, or low levels of calcium.
The most important part of osteoporosis treatment is preventing bone fractures. We generally combine different types of treatments to slow down your bone loss and strengthen the bone tissue you have.
The most common osteoporosis treatments include:
Regular exercise strengthens your bones and all their supporting tissues (e.g., muscles, tendons, and ligaments). Weight-bearing exercise strengthens your muscles and helps improve your balance, preventing bone-breaking falls.
Good types of exercise are walking, yoga, Pilates, and tai chi; all can improve strength and balance without taxing your bones. You might need to work with a physical therapist to find the right combination of exercises and movements for you.
Calcium and vitamin D are crucial for bone health. Your provider will tell you whether an over-the-counter supplement is OK or if you need prescription strength. They’ll also let you know what dose you need and how often you need to take it.
In addition, you may need medications formulated for osteoporosis: Two of the most common medications doctors use are hormone replacement therapy (HRT) and a class of drugs called bisphosphonates. Be advised that these come with some risks, so make sure you understand what those are before you start taking them.
If you’ve gone through menopause, your bones are at risk. Fortunately, the team at Capital Women’s Care in Frederick and Mt. Airy, Maryland, can help ensure your bones stay healthy and safe. To learn more, or to schedule a consultation, call our nearest office or click on our website’s contact page.
