by Marcelle Pick, OB/GYN NP
The battle cry around osteoporosis and women has only been raised in the past twenty years, coinciding with incomplete research put forth by the pharmaceutical industries in support of HRT. While accelerated bone loss and fractures have always been a concern for people over 65, younger women got dragged into the fray when research indicated that the natural, gradual decline in bone loss accelerated in the 3-5 year period after menopause.
I want you to understand first and foremost that losing bone is a natural—in fact vital process. Only bone loss (also called resorption) can trigger healthy new bone formation (also called deposition or formation). As with all things in nature, good bone health relies on a balance between this action and counter-action, like breathing out and breathing in.
New bone is strong, flexible with the ability to forbear both compression (running, jumping) and tensile (flexing) pressure. In some women, the balance between bone growth and loss gets severely thrown off —when this begins happening is highly individual, but estimates suggest as much as 20 years before menopause.
What about the idea that menopause triggers bone loss? Most women aren’t given a bone mineral density test (BMD) until mid-life unless they experience an unusual fracture (like a hip fracture) at an early age. Who’s to say what’s normal for you if you don’t have a baseline to compare to?
What’s more, advancements in technology allow us to diagnose bone density more efficiently—a factor that must be taken into account when you look at the statistics on osteoporosis risks. It may seem as if the condition is on the rise, but we only recently developed appropriate tools for measurement!
I think it is no coincidence that much of the fuss about osteoporosis coincides with the marketing of HRT to the public. Since bone loss accelerates briefly during menopause, osteoporosis has come to be viewed as a treatable “symptom” of the “disease” of menopause—yet another indictment of natural aging that women can feel bad about and “cure” through potentially hazardous (and expensive!) drugs.
What’s given less press is the fact that bone strength depends on several factors—not just density— and focusing so much on one side of the equation (inhibiting resorption) to the exclusion of the other (supporting new bone growth) comes at its own price.
The fact is bone strength requires a balance of both and this is influenced by many factors: genetics, body frame size, diet, calcium intake, vitamin D levels, hormonal balance, stress, and lifestyle. And because bones are constantly regenerating, every positive step you take to support their function will make a big difference.