Osteoporosis in Women (and Men)

Osteoporosis and Bone Health

Our bodies are like well-built houses, made of natural materials and impressive architectural strategies: joints, valves, even ornamental features that serve the cause of beauty. As with houses, maintenance and upkeep are required. If our bones are like the foundation and structural support of our bodies, age brings termites and water damage.

Osteoporosis is a combination of two Greek words meaning “bone” and “porous". The determining factor physicians use in diagnosing osteoporosis is “bone mineral density,” or BMD, which refers to the amount of mineral matter per square centimeter of bone. If your bone density has deteriorated 2.5 times below what it was at peak health, you will be diagnosed with osteoporosis. In architectural terms, think of this as a stress test of the critical supports of your house.

While osteoporosis can strike as early as your 40s, doctors recommend that anyone over the age of 65 get screened for the disease. It is estimated that about 10 million Americans suffer from it.¹

Cracks in the House

There are no formal symptoms of osteoporosis…until the house falls down. Or, more likely, cracks. The most common and most dangerous problem associated with the disease are fractures. A person with osteoporosis is much more likely to fracture a bone—especially joint bones like the wrist, shoulder, elbow, and hip—doing some normal activity than they were when they were younger and healthier. Falls can be devastating.

There is no known “cause” or “beginning” of osteoporosis, though decreases in the production of sex hormones estrogen and testosterone are likely culprits, as are deficiencies in calcium and Vitamin D (more on that that below). Once osteoporosis has begun, it is irreversible, but its effects may be mitigated by lifestyle changes, medication (in those with fractures), and by taking precautions against falls and fractures.

The Risk to Women

Ladies, you are at increased risk for developing osteoporosis. Those are just the facts. Of the 10 million Americans suffering osteoporosis, fully 80% are women. The reasons for this are fairly clear:

• Smaller bones. Women’s smaller, thinner bones increases the risk - there is simply less density to erode.
• Estrogen. One of the functions of the female sex hormone estrogen is to protect bones. Estrogen levels drop significantly when a woman reaches menopause. Hence, vulnerability to osteoporosis skyrockets.

While all women may develop osteoporosis, White and Asian women are at much higher risk than African American and Latina women. However, one theory holds that the lower incidence for African American and Latina women may be due in part to under-reporting and too few screenings.

Read: What Every Woman Should Know About Bone Health

Other Risk Factors

As we’ve said, the most important risk factors for developing osteoporosis are being a post-menopausal woman. The smaller the bones, the better the chances of developing osteoporosis. But these are “non-modifiable risks,” meaning there’s nothing you can do about these. There are some things that are modifiable, though:

• Diet. Critical to an osteoporosis-fighting diet are calcium and Vitamin D. This means: get enough dairy! Yogurt, cheeses, milk products  are key. If you are lactose intolerant, many greens (bok choy, mustard greens, broccoli, to name a few) are full of calcium, as is calcium-fortified orange juice. Supplemental calcium and Vitamin D can help.
• Smoking. As with everything else, excessive drinking and any smoking is considered a risk factor. Provocatively, new research suggests that smoking by middle aged men actually more greatly increases their risk of developing osteoporosis than smoking by women.² But make no mistake: smoking increases the risk in both genders.

Preventive Measures

Robust living can help prevent osteoporosis. Because bones live, they can be strengthened by exercise and weakened by laziness, just like the muscles.

• Screenings. Like mammograms and colonoscopies, routine osteoporosis screenings are essential. For some reason, there is a myth that osteoporosis screenings are harmful or painful. They are not! mot screenings simply consist of placing your foot in a scanner that is used to test the bone mineral density of your heel, because the heel bone is similar to the hip bone. It’s quick and painless. Do it!

But what about drugs?

• Calcium. While doctors recommend getting your daily calcium through food and drink, calcium pills have been shows to fortify the body and strengthen bones.
• Vitamin K. Vitamin K is a recent entry into the pantheon of the drugs recommended for osteoporosis prevention. Vitamin K is thought to activate certain proteins involved in bone mass formation and maintenance. Dr. Vivian Golschmidt of “Save Our Bones” goes so far as to call Vitamin K a “knight in shining armor” for osteoporosis.³
• CoQ10 and antioxidants. Research into the role antioxidants play in all areas of our health is coming in at a feverish pace, and there now seems to be role in supporting bone health. Research suggests that CoQ10 plays a fundamental role in maintaining bone health and supporting bone density. 

Osteoporosis in Men

Finally, a word must be said about men. While osteoporosis strikes women at a rate of 80%, 20% of 10 million is no small number. Men, you are at risk too! Your risk is particularly high if you smoke, as mentioned, but non-smoking men are also at risk. A big problem that has recently been pointed out is that osteoporosis screenings for post-fracture men are not routine. That’s really a shame. If men of advancing age suffer a fracture, they should insist on a screening.

Yes, our bodies are like houses. Age happens, weather happens. Until we find a way to raze the foundation and build anew, we have to do whatever we can to make sure our foundation and support beams are solid and healthy. Thankfully, supplemental therapy, exercising, and regular screenings are a lot less stressful and a lot cheaper than total home makeovers. 

1. National Osteoporosis Foundation. “What Women Need to Know.” https://www.nof.org/articles/235
2. National Jewish Health. “Male smokers at higher risk than females for osteoporosis, fractures.” March 5, 2015. https://www.eurekalert.org/pub_releases/2015-03/njh-msa030515.php
3. Goldschmidt V. “Vitamin K: your osteoporosis knight in shining armor.” https://saveourbones.com/vitamin-k-osteoporosis/
4. Kalyan S, Huebbe P, Esatbeyoglu T, Niklowitz P, Côté HC, Rimbach G, Kabelitz D. Nitrogen-bisphosphonate therapy is linked to compromised coenzyme Q10 and vitamin E status in postmenopausal women. J Clin Endocrinol Metab. 2014 Apr;99(4):1307-13.