Wellness for women with Dr Sarah Callaghan

Women’s Health continues to be a hot topic and a question this week has brought the focus on bone health.

Dear Dr Sarah,

I am 58 years old now and my periods stopped around 10 years ago. My Mum got osteoporosis in her 60s and had a fall a few months ago when she broke her hip. She also has pain in her back and the doctor said it was due to osteoporosis affecting her spine.

I do smoke but have cut back a lot. I heard that can be bad for your bones. Is there anything I can do to prevent myself having the same problems as my Mum? Should I be thinking about HRT? Is that good for your bones?

Thanks for your help,

Marie

Dear Marie,

Osteoporosis is a common bone disease affecting women in particular, but it is usually a silent problem until a person develops a bone break or fracture. That is why screening for osteoporosis is so important. Osteoporosis and hypertension are silent diseases that can have a major impact on your ability to live longer with a healthy body.

The best test to detect osteoporosis is a scan called a DEXA scan, which is like having an x-ray done and your doctor can arrange this. Most women should have their first DEXA scan at the age of 65 as a baseline test and at regular intervals after that, depending on the result.

If, however, you have risk factors for osteoporosis you will need to start your DEXA scan imaging at a younger age. Risk factors include smoking, having regular doses of steroid medications, having Coeliac or Crohn’s disease, a family history of early onset osteoporosis, being underweight or taking alcohol above the low risk drinking limits.

An early menopause under the age of 45 years is also a risk factor. The good news is that there is lots you can do to keep your bones healthy, and there are excellent treatments available if you do develop osteoporosis.

Your DEXA scan result may be normal in which case you will need to maintain healthy bone protective habits. It may show osteopenia which means the bones are not as strong as normal, but it has not yet reached the osteoporosis stage.

This means you can work hard on the healthy bone protection strategies and will need to have more frequent monitoring of your bone health with DEXA scans.
If the DEXA scan shows osteoporosis you will need treatment and your doctor will talk to you about the options. There are lots of safe effective treatments that can really help.

HRT offers excellent bone protection while you are taking it.
Healthy bone protective habits include daily exercise, which ideally should be weight bearing such as walking or strength exercises. There are nice exercise fact sheets available at www.irishosteoporosis.ie .

Nutrition is also important to ensure you have adequate calcium in your diet. One of the easiest ways to do this is to have three servings of dairy a day in your diet. This could be a glass of milk, a yoghurt and a matchbox sized piece of cheese.

These can be low-fat. If you do not eat dairy there are other dietary options to obtain your calcium intake. Again there is lots of information at www.irishosteoporosis.ie. If you cannot meet the calcium intake from your diet, you can take a calcium supplement, which your doctor will prescribe.

Vitamin D is also very important for bones and you will need to take a vitamin D supplement which your doctor will prescribe. This is something you will need to take lifelong.

The important message is to be aware of your bone health as an issue as you turn 50 years of age. And start to look at how best you can protect your bones. Talk to your Mum, aunts, sisters about their bone health. It may be something that they are not aware of.
Thanks for raising this important issue.

As with many things, prevention really is the best cure!

Sarah