Reduce the risk of osteoporosis & keep your skeleton strong
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Half of women and 20% of men over 50 will break a bone because of osteoporosis, where your bones become weak and break more easily, but you can help reduce your risk. Osteoporosis, which is Latin for ‘porous bones’, is a symptomless condition and you won’t know if you have it unless you’ve had a fracture or a bone scan. Our bones are made of living tissue, where two different types of cells constantly work to make bone, and to break it down. Healthy, strong bones should be able to withstand a fall from standing height without breaking.
Losing bone density is a normal part of ageing, but it happens much faster than normal for some people, and can lead to osteoporosis and an increased risk of fracture. Doctors can test for osteoporosis by referring you for a bone density scan, or DEXA scans.
Osteoporosis and the menopause
Yes, increased bone loss is yet another effect of the menopause, linked to oestrogen deficiency, and women lose bone rapidly in the first few years after the menopause. Women are more at risk of osteoporosis than men, particularly with early menopause (before 45) or if they’ve had their ovaries removed.
Reflecting this difference between the sexes, the condition has a mention in the government’s new Women’s Health Strategy, which also admits that ‘Not enough focus is placed on women-specific issues like miscarriage or menopause, and women are under-represented when it comes to important clinical trials. This has meant that not enough is known about conditions that only affect women, or about how conditions that affect both men and women impact them in different ways.’
One of the effects of HRT is to prevent bone loss, although it’s unlikely to be prescribed for this. According to the Royal Osteoporosis Society (ROS): ‘the current thinking is that HRT is generally safe and effective for menopausal symptoms. If used on a short-term basis, the benefits for most women will outweigh any risks. Most experts would also consider HRT as a useful option for osteoporosis treatment in women between 50 and 60, after a discussion of individual risks and benefits. HRT might be especially useful for women who also have menopausal symptoms. You will usually be offered other bone-strengthening medications after the age of 60 years.’
Other risk factors for osteoporosis
The condition can affect people of all ages, and causes include:
– family history, especially a parent’s hip fracture
– being underweight
– heavy drinking and smoking
– lack of regular exercise
– eating disorders such as anorexia or bulimia
– long-term use of steroids and certain other medicines that can affect bone strength or hormone levels
– other medical conditions such as inflammatory conditions, hormone-related conditions, or malabsorption problems
How to protect against osteoporosis
It’s too late to do anything about the first preventive measure, which is to lay down lots of healthy bone in childhood, by eating a calcium-rich diet. But there’s still time to take steps… In fact, taking steps, in the form of weight-bearing exercise is a great idea.
Bones get stronger when you use them, and the most effective exercise combines weight bearing with impact. Low-impact activities include walking and stamping, moderate includes running and high impact includes activities that involve jumping, such as star jumps or volleyball.
Strengthening your muscles is also beneficial as muscles are attached to bone and working your muscles means your bones work, too.
Stop smoking and cut down on alcohol. Drinking obviously increases your likelihood of tripping and falling over, as well as affecting bone structure.
Eat foods that are rich in calcium –important for maintaining bone health – such as leafy green veg, dried fruit, tofu and yoghurt.
Vitamin D is essential for healthy bones and in the UK taking a supplement from autumn to spring is recommended although ROS research says that only 37% of Brits realise that you can’t get vitamin D from sunlight between the end of September and beginning of April in the UK.
Measure your height regularly – if you get shorter this could be a sign of osteoporosis.
You can take an online test to see if you’re at risk on the amusingly named Sticks and Stones website, home of the Global Osteoporosis Foundation.
Adrienne Wyper is a health and lifestyle writer and regular TNMA contributor.
Discussion (26 Comments)
My understanding is that there’s very little (if any?) medication available to treat osteoporosis. We know that receiving a diagnosis often makes us fearful of movement, more vigilant and nervous. A scan is only ever a snapshot of that moment in time – it can’t give any historical context, so we may have been living with the condition perfectly happily for many years.
Personally, I won’t be having any scans, but I will be actively moving, increasing my weight bearing and impact based exercise, eating well and cutting down alcohol. Doing what I can to maintain good physical and mental health and not worrying about things outside my control.Ellen Tannenbaum says:
I am in the USA and we have a number of medications that are prescribed for osteoporosis. Although they don’t reverse the condition they can reduce the rate of bone loss. https://www.mayoclinic.org/diseases-conditions/osteoporosis/diagnosis-treatment/drc-20351974
Kathryn Ballentine says:
Yes, I have osteopenia, and in December will have my second annual Reclast infusion. Reclast increases bone density over a three-year regimen of annual infusions.
I follow all of the other recommendations as well. I strongly recommend balance exercises.Rowan says:
I don’t wish to sound flippant but yes, in the US there is a drug for everything- good for the pharma industry.
I try to walk everywhere, do pilates and yoga – eat well and live moderately while enjoying life.
I think that’s the best solution / preventative method
Christine Donne says:
A very interesting post today about osteoporosis. And unfortunately, one that will affect many of your readers sooner or later.
I was diagnosed with ‘thinning bones’ about 15 years ago, originally by my dentist. He suggested I should have a bone scan. I was 66 so I was not a surprised with the result. My GP suggested I might overhaul my diet to include more calcium rich foods & suggested I took various vitamin supplements, including sea calcium, Vitamin K2 and vitamin D – I was already taking HRT. I also started pilates exercises which are incredibly good for building core strength. I’ve always been on the slim side and was bulimic for many years so I was a real contender for osteoporosis. Thankfully, so far with my continued exercising, (Dancing in the kitchen to pop music) and alternate days of weight lifting (done at home) I’m doing OK. My GP has reluctantly allowed me to continue with HRT patches and I’m sure this helps to keep me active and still able to enjoy fashion, theatre etcetera. .Each day day is a bonus! Long live TNMAI would like to comment on Catherine Annis’s response. On the contrary to making me fearful of movement, more vigilant or nervous; I welcomed the diagnosis of the scan. It spurred me on to improve my strength & well being & my husband encouraged me. Sadly, I’ve been a widow for 7 years but even now at almost 82, I continue with the extra vitamins, good diet & excercise. The advice I had 15 years ago was excellent & although I agree that osteoporosis cannot be reversed, (yet), it is possible to slow down its progress with small changes to lifestyle.
Four years ago I tripped over a raised manhole cover in the city & flew head long onto the pavement. I suffered severe bruising to my left thigh, knee, ankle, shoulder & elbow & had nasty grazing to my right arm & hand. It was over 8 weeks before the bruising finally disappeared. I’m only 5’4′ & very slim & according to my GP it was a miracle I hadn’t broken any bones. His advice to me was to carry on doing my exercises & keep taking the tablets! I’ve never smoked but I do enjoy a glass of red wine a few times a week with friends. I also have my name down to join a ‘Silver’, (ballet class for seniors) next term. Keep moving.I would like to add another comment. On the contrary to making me fearful of movement, more vigilant or nervous; I welcomed the diagnosis of the scan. It spurred me on to improve my strength & well being & my husband encouraged me. Sadly, I’ve been a widow for 7 years but even now at almost 82, I continue with the extra vitamins, good diet & excercise. The advice I had 15 years ago was excellent & although I agree that osteoporosis cannot be reversed, (yet), it is possible to slow down its progress with small changes to lifestyle.
Four years ago I tripped over a raised manhole cover in the city & flew head long onto the pavement. I suffered severe bruising to my left thigh, knee, ankle, shoulder & elbow & had nasty grazing to my right arm & hand. It was over 8 weeks before the bruising finally disappeared. I’m only 5’4′ & very slim & according to my GP it was a miracle I hadn’t broken any bones. His advice to me was to carry on doing my exercises & keep taking the tablets! So, I try to keep on moving.Louise says:
Hi, I found your comment really interesting and insightful. Thank you. Do you recommend any particular brand and dose of the vitamins you take? I have just been diagnosed with osteopenia and want to start taking supplements.
Anita says:
I have been diagnosed with osteopenia and my doctor suggested Vitamin D – I take one tablet 1000iu daily, (this dosage means I only need one tablet a day and is my only criteria for purchasing different brands) walk my dog every day and do pilates and yoga up to 3 times a week.. I have fallen twice, since diagnosis – tripping over things and have only suffered bruising.. so I feel the Vitamin D and regular exercise are definitely making an impact.
Cindy says:
Similar to the feature on menopause, this article has wonderful information and suggestions to maintain our health, regardless of age.
Jude says:
Thank you for highlighting this important issue. I’m 68 and have exercised since my teens. My diet is and always has been good, I haven’t smoked and drink very moderately and I have been diagnosed with severe osteoporosis after fracturing my spine. It came as a shock. I’m fortunate to be offered a treatment over 2 years which will help stop deterioration and build density. I tell everyone to take Vitamin D as that helps calcium absorb.
Dianne Jackson says:
Hi Jude. Would the drug you’ve been prescribed be Teriparatide by any chance. I’ve just been prescribed this for a 2year course and somewhat apprehensive because of the side effects but feel somewhat backed into a corner following dexa scan results of -2.4 and -2.5 showing a marked decline of my first dexa scan in 2018 (-1.9) following a stress fracture in my tibia which has refused to heal causing almost 4 years of not being able to walk and a course of steroids that have possibly accentuated the decline. If it is Teriparatide you’re taking any information would be hugely appreciated
Mrs Tonia says:
Thanks Adrienne for this helpful discussion and the TNMA readers comments also. I’m fortunate not to have this affliction but my sister has had hip surgery, breast cancer twenty years ago and now diagnosis via blood tests and scanning of osteoporosis of the spine. She’s slim and very careful with her diet and adding calcium but she has had several falls. She attributes her present condition to a five year course of tamoxifen post radiotherapy. She has had and continues to have a very demanding professional life in a creative industry and hasn’t been able to spend time in gyms though she does pound the pavements and parks on her scarce days off. Recently she told me she may start on some form of medication in addition to dietary priority of vitamin D.
I’m hoping for her that this might work and stave off future complications. My best wishes go to all sufferers.Lizzie Guinn says:
A few years ago I was diagnosed with GCA (Giant cell arteritis, formerly known as temporal arteritis) which necessitated a course of steroids, starting with a high dose and gradually tapering over a period of 2 years. I had a Dexa scan which showed me to be osteopoenic – not very surprising apparently as I am 5ft 2 and of slight build. I was prescribed bisphosphonates to build bone density, but my dentist strongly cautioned against them, as did the GCA support group. Instead I bought myself a rebounder to exercise on at home and hopefully increase bone density and thoroughly recommend it along with regular Pilates. My diet has always been healthy with an emphasis on fresh vegetables and I had plenty of dairy produce growing up as my grandparents had a dairy farm. Our generation also had the ‘treat’ of our bottle of milk at school break! am now at 74 the same height as I was in my teens so I am hopeful that the strategy has worked, though I doubt I will manage to emulate my mother who has just celebrated her 102nd birthday and still lives independently. However she is now noticeably smaller than me these days.
Thank you for a very interesting article.Jill Hunter says:
Thank you for sharing the article above on osteoporosis. I subscribe to the Royal Osteoporosis Society because I have severe spinal osteoporosis. The Society is continually campaigning for GPs to recognise the symptoms well before a bone is broken. I went to my surgery for several years with back pain, was not examined and sent away with prescriptions for painkillers. In agony, I took myself off to a spinal surgeon et voila – osteoporosis. Goodbye walking, sailing and skiing. I rattle with pills and exercise regularly to prevent the disease becoming worse. Other sports can take the place of those lost, ie snooker! Some good news – a package was delivered today with some super stuff from COS – is shopping a sport?
Sarah P says:
Stacy Sims has an excellent book named “Next Level” on the recent research about menopause and exercise. I recommend it!
After being diagnosed with osteoporosis 5 years ago aged 61 I feel that there should be more available information to women . We are only now talking more openly about how hormonal changes and hereditary conditions affect our lives . I wasn’t aware that a hip fracture my ageing mother suffered was a sign of osteoporosis. Medication is available but we have a long way to go . It works for some . Keep active !! Walking and weight bearing exercise is one of the best ways to keep strong .
Pamela Redmond says:
I don’t like the suggestion that people with osteoporosis bring it on themselves with poor diet or heavy drinking. Lots of women with osteoporosis, like me, always did everything “right” and still receive this diagnosis. And while taking vitamin D and exercising are positive for everyone, they don’t rebuild bone density. Not much is known about this disease and the treatments are risky and not that effective, but blaming the victims only compounds the problem.
Thank you for commenting, Pamela. I’m sorry you feel this way. Nobody is victim-blaming, just highlighting a number of causes of osteoporosis, which as Adrienne points out, affects 50% of women over 50.
Goddessinthedetails says:
Thank you so much for highlighting this. I recently had a DEXA scan and was diagnosed with osteopenia, not too bad in general but quite severe in the neck of the femur, which is where you tend to break when you fall in old age. As a result, I refused the drugs I was being offered to prevent a reoccurrence of breast cancer and am embarking on a programme of exercise – quite apart from the benefits to bones, post menopausal women have a 68% reduction in the risk of breast cancer reoccurrence if they exercise to moderate intensity for 150 minutes a week. (Source: the NHS physio to whom I was referred). Caveat: the Predict computer programme showed a very very small benefit to me from taking the drugs, so everyone is different, but it’s certainly an eye-opener as to how much you can help yourself by investing your time in yourself. I think as women we tend to put ourselves last. It’s so easy to neglect your health when you’re a busy working mum and/or caring for an elderly parent. I feel as if I’ve set a bad example to my daughter in my own stressed selflessness but can set a good example now in my 60s.
Julia K. says:
Yoga is terrific, not only for stretching and connecting with the breath, but to maintain core strength and balance in order to reduce the chance of falling as we age. I am a runner and added weight training at age 39. I find it’s fairly simple to fit a 20 minute YouTube yoga video into my schedule at home. I like Yoga with Adriene. She has a huge library available and many beginner videos. It’s never too late to start!
Martine Large says:
Another tip is to improve your balance to reduce the chance of falling. My aunt, who’s 87, still stands on one leg while cleaning her teeth, and now I do the same.
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I’ve taken up weight lifting, in a modest way. I go to my local sports centre for Bodypump, a series of exercises using weights to build strength. My weights are not heavy but after two months I can see and feel the difference in muscle tone and definition. I now wear sleeveless dresses happily. I’m 67 and feel really fit. Recommend it.