I often work with women who lose 8-10% of their bone mass during the menopausal transition — with some women losing up to 20%.

But just how does this happen to women? When does accelerated bone loss begin? How long does it last?  How much bone is generally lost? 

Recently, UCLA researchers reported results of a 10-year study aimed at answering these very questions. These scientists followed an ethnically-diverse group of several hundred U.S. women for 5 years before their last periods through the 5 years after their last periods. 

What’s new and important about these research findings?
Previous researchers noted a 10% overall bone loss during the10 years around menopause and the UCLA scientists expected to find the same results…and they did see roughly the same 10% loss.

What’s new, however, is that this study clarified that menopausal bone loss is not spread evenly over the 10-year transitional period.  Rather, most of this bone loss occurred in the 3-year period starting 1 year before a woman’s last period and ending 2 years after her last period — known as “trans menopause.”
 

Here are the detailed findings: 

• Cumulative spinal bone loss over the 10-year period was 10.6%.
• Cumulative hip bone loss over the 10-year period was 9.1%.
• Most of this bone loss occurred in the 3-year time frame that covered 1 year before and 2 years after the last period.  During these 3 years, spinal density decreased by 7.6% and hip by  5.8%.
• The rate of bone loss slowed down as women moved into post-menopause, defined as 2-5 years after the last period. For example, the rate of bone loss for Caucasian women during this post-menopausal period slowed to 1.04% a year. 

What you can do…
Since you can’t really know when the year before your last period will occur until you actually have experienced your last period, it’s a good idea to get started right away on a strong Better Bones Program at the first signs of perimenopause. Even better, take action in your mid-twenties when bone loss tends to begin.

Reference:
Greendale, G.G. et al., Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: Results from the Study of Women’s Health Across the Nation (SWAN), Jr Bone and Mineral Research, Vol 27, io. 1m Jan 212:1110118.

As an anthropologist, I have the opportunity to study how different cultures react to change. I enjoy seeing how an idea that at first seems impossible or “radical” eventually becomes accepted by the mainstream.

For example, in January of 1992, AT&T released the first video-telephone, costing a mere $1,499. How many of us realized then that 20 years later it would be common to be video chatting on our cell phones… even on a daily basis?

Thinking back to my work 20 years ago, I was one of the few advocating that there was more to osteoporotic fractures than low bone density and also, that women had natural options to strengthen their bones. Now, let me be clear, I wasn’t saying these things because I was a genius — I was saying them because they were supported by impressive research. But then, as timing would have it, the natural approach became overshadowed with the approval of Fosamax in 1995.

That’s why I was delighted recently to see that leaders in the field are now expanding their perspective regarding what is the best approach for bone health. In a January 18, 2012 article in The New York Times titled “Patients With Normal Bone Density Can Delay Retests, Study Suggests,” medical reporter Gina Kolata writes that the study, which was published in The New England Journal of Medicine, “is part of a broad rethinking of how to diagnose and treat” bone loss.

Kolata then points out how the medical community itself isn’t convinced bone drugs are your best option for bone health. To be exact, Kolata writes “…medical experts no longer recommend the medicines (bisphosphonates) to prevent osteoporosis itself. They no longer want women to take them indefinitely, and no longer consider bone density measurements the sole defining factor in deciding if a woman needs to be treated.”

I am also impressed by Dr. Ethel S. Siris, an osteoporosis researcher at Columbia University interviewed by the Times, who noted that osteopenia is a risk factor, not a disease. I am hoping to talk with Dr. Siri about her work in an upcoming blog post.

I find it encouraging that attitudes seem to be shifting away from such a narrow view of bone health. Let’s hope that the “radical” thoughts about bone drugs and bone health advance as quickly as phone technology!

References:

The New York Times, Kolata, G. Patients With Normal Bone Density Can Delay Retests, Study Suggests, http://www.nytimes.com/2012/01/19/health/bone-density-tests-for-osteoporosis-can-wait-study-says.html?_r=1,(Accessed 01.31.12)

Gourlay, Mararet L, M.D., M.P.H2012. Bone-Density Testing Interval and Transition to Osteoporosis in Older Women. N Engl J Med 2012; 366:225-233 http://www.nejm.org/doi/full/10.1056/NEJMoa1107142 (Accessed 01.31.12)

Happy 2012! It’s time for my annual wish list for bone health in the coming year. And this time, I’m also including a suggestion — or two — along with each wish — that can serve as a little push for its fulfillment. After all, our wisdom and our collective focus can actually make wishes come true — especially important to remember in an area as essential as bone health!

My 2012 wish list:

1. 2012 will herald a new age of partnership between physicians and their patients. Physicians will partner with each individual woman to develop a unique bone strengthening program appropriate for that woman and the way she lives.

And just in case this wish needs a little push… If your healthcare provider thinks that your bone health situation is serious enough to warrant use of a bone drug, then we know it’s serious enough to warrant a full medical workup looking for the hidden causes of bone loss. Take my osteoporosis medical workup recommendations to your doctor and say you also are concerned about your bone health and would like these tests to look for possible causes of osteoporosis.

2. Everyone will be tested for vitamin D adequacy. It will be widely recognized that as many as half of all osteoporotic fractures could be prevented by maintaining a minimum 32 ng blood level of vitamin D. This awareness will inspire universal vitamin D testing.

And just in case this wish needs a little push… If you can’t obtain vitamin D testing from your healthcare provider, you can order an at-home vitamin D test online from public interest groups such as the Vitamin D Council and Grassroots Health.

3. Everyone who experiences a fracture that occurs without great trauma will take the hint from nature and get serious about implementing my Better Bones Program.

And just in case this wish needs a little push … Make it a New Year’s resolution to spend some time reading my articles about bone health. You will see that our Better Bones Program offers a life-supporting approach that fortifies bone while it strengthens your entire body. Even if you feel your fracture was due to trauma, you will be inspired to further strengthen your bone by joining us in our natural Better Bones Revolution.

4. The “Alkaline for Life” concept will become a household saying and even restaurants will offer alkalizing meal alternatives.

And just in case this wish needs a little push… Make it another of your New Year’s resolutions to include two cups of vegetables for lunch and dinner, use more spices and herbs, consume two or three fruits a day and reduce your intake of excess protein, caffeine, sugar, alcohol and processed foods. And explore more options!

5. Chronic stress, excessive worry, and fear will become recognized as key emotions that disrupt neuroendocrine functioning and weaken bone. Meditation, stress reduction techniques, and mindful exercises such as yoga, tai chi, and qigong will become essential elements of all osteoporosis prevention and treatment programs.

And just in case you get this message before the insurance companies do… Commit yourself to creating peace and inner quiet on a daily basis. Take 10-15 minutes a day, close your eyes and just relax. Notice your breath and entertain the idea that all is well, even amid any turmoil in the present moment.

Let’s make all of our wishes come true in 2012!