How to Prevent Bone Loss Post -Menopause: Exercise and Nutrition

What Causes Bone Loss Post-Menopause?

Catherine Winslow, MD: The primary reason for bone loss during and after menopause is the decline in estrogen levels. Estrogen is a key hormone that protects bone density. Additional risk factors for osteoporosis include:
•    Low body weight
•    Smoking
•    Family history of osteoporosis
•    Excessive alcohol use
•    Certain medications, such as corticosteroids
•    Medical conditions that affect bone health

What is the Role of Calcium and Vitamin D?

Catherine Winslow, MD: Consuming calcium-rich foods (such as dairy products, leafy greens, and fortified foods) and supporting vitamin D levels through sunlight exposure or supplements are essential. These nutrients work together to strengthen bones and prevent loss.
 

Bone mass reaches its peak around age 30, but it begins to decline during the menopause transition. During this time, women typically lose 10-12% of bone mass in the hip and spine. After menopause, bone density continues to decrease at a rate of about 0.5% per year, with a total loss of approximately 30% by age 80. Calcium and vitamin D are crucial to help slow bone loss.

How is Bone Density Monitored?

Catherine Winslow, MD: The gold standard for measuring bone density is the DEXA (dual-energy X-ray absorptiometry) scan. Postmenopausal women with risk factors for osteoporosis or those aged 65 and older should be tested. Risk factors include:
•    History of fractures
•    Thin build
•    Family history of osteoporosis
•    Smoking 
•    Diseases and medications harmful to bones 
Speak with your health care provider about the frequency of testing based on your risk profile.

What are the Early Signs of Osteoporosis?

Catherine Winslow, MD: Often, the first sign of osteoporosis is a fracture, especially in the hip, spine or wrist. Unfortunately, bone loss is usually silent, with no noticeable symptoms until a fracture occurs, underscoring the importance of screening and preventive care.

How Does Exercise Impact Bone Health?

Catherine Winslow, MD: Weight-bearing exercises, such as walking and strength-training activities using resistance bands or weights, are excellent for bone health. While exercise doesn’t directly increase bone density, it helps slow bone loss, improves muscle strength and enhances balance to prevent falls.
For maintaining bone health, aim for at least 30 minutes of weight-bearing exercise, such as walking, five times per week. Additionally, strength and resistance training should be done at least twice a week for 30 minutes per session. Consistency is key.

What are Safe Exercises for Those with Osteoporosis?

Catherine Winslow, MD: For those with osteoporosis, weight-bearing exercises are helpful in slowing bone loss. Incorporate strength, resistance, mobility and balance exercises to prevent falls. Tai Chi is an excellent option for improving balance and strength. Avoid activities that increase the risk of falls or involve high-impact movements.

How Can Lifestyle Adjustments Help Prevent Fractures?

Catherine Winslow, MD: Reducing fracture risk involves several strategies:
•    Medications: Menopausal hormone therapy (MHT) can reduce osteoporosis risk if started within 10 years of menopause, particularly for women with vasomotor symptoms, like hot flashes or night sweats. Other medications are available for those who cannot take MHT.
•    Fall Prevention: Strategies to prevent falling include strength and balance programs, correcting vision issues, removing home hazards and avoiding icy conditions to reduce fall risk.
•    Nutrition and Exercise: Adequate calcium, vitamin D and regular exercise are essential.
 

If you’re experiencing symptoms related to menopause or have concerns about bone health, schedule an appointment with a physician or advanced practice provider experienced in menopause management.

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