With Endocrinologist Angela Boldo, MD.
By age 80, nearly 80% of women will have experienced significant loss in bone density. A third will have full-blown osteoporosis. It’s a condition that affects almost 10 million Americans, leading to spinal fractures, hip breaks and more.
We spoke with First Physicians Group Endocrinologist Dr. Angela Boldo about when to start screening for osteoporosis, managing osteoporosis, and even how to keep the condition at bay.
WOMEN ARE AT GREATER RISK OF OSTEOPOROSIS THAN MEN
“Women develop osteoporosis more than men because they lose estrogen production with menopause and this increases bone resorption,” says Dr. Boldo. “So all women will start losing some bone strength.” Exactly how much is largely determined by genetics and how strong one’s bones are before this reabsorption begins. The result is typically osteopenia, with about a third of women developing osteoporosis.
Men develop osteoporosis less frequently, due to lifelong testosterone production.
“Unfortunately,” says Dr. Boldo, “this means men don't get screening for osteoporosis and find out only after they have a fracture.”
Osteopenia vs Osteoporosis
Both osteopenia and osteoporosis indicate loss of bone density. The difference is in severity.
Osteopenia is a warning sign. Loss of bone density is noticeable, but there is no significant increase in fracture risk. Take action to avoid osteoporosis, if possible.
Osteoporosis means loss of bone density has progressed and fracture risk is high. Treatment is warranted.
OSTEOPOROSIS SCREENING BEGINS AT 65 OR AFTER MENOPAUSE
Official guidelines recommend women generally begin screening for osteoporosis at age 65, absent significant risk factors. And one of the most important factors to consider, says Dr. Boldo, is menopause.
“I tell patients to begin screening five to 10 years after menopause or at age 65,” she says. “Because sometimes patients in their early 60s already have osteoporosis. Some women have menopause in their 40s and should be screened in their 50s.”
SYMPTOMS OF OSTEOPOROSIS
Osteoporosis has almost no noticeable symptoms before causing serious injury.
“And that's the biggest problem with osteoporosis” says Dr. Boldo. “You don't feel anything until you suddenly break a bone.”
“But if you notice a decrease in height,” she adds, “that's a big warning.”
RISK FACTORS FOR OSTEOPOROSIS
Significant risk factors for osteoporosis can include certain medications, hyperthyroidism, and even smoking, but perhaps the greatest indicator is family history.
“If you have family members who broke their hip or had compression fractures,” Dr. Boldo says. “I would start screening right at menopause.”
Screening for Osteoporosis
A bone density scan takes approximately 15 minutes and measures bone density in the hip and spine, where fractures are of most concern, and sometimes the radius of the forearm.
If the results are normal, repeat the scan in five years. If the scan detects osteopenia, screening is recommended every two years to measure the rate of decline.
OSTEOPOROSIS DIET & NUTRITION
Calcium and Vitamin D are crucial to any diet aimed at avoiding or managing osteoporosis.
“Those are the things that can make a difference,” says Dr. Boldo. She recommends 1200 milligrams of calcium each day, through diet or supplements, and 2000 units of vitamin D via supplements, which helps the body absorb calcium.
“Sometimes I even recommend this to my patients before menopause,” she says. “Because we want to make sure your bones are strong before you even go into menopause.”
For more diet and nutrition tips from Dr. Boldo, click here.
EXERCISES FOR MANAGING OSTEOPOROSIS
Weight-bearing exercises are great for managing osteoporosis. This can include stairs, squats, low-impact aerobics, a brisk walk or even dancing.
“I usually recommend at least 30 minutes a day,” says Dr. Boldo. But the pool doesn’t count. “Exercises in the pool are great,” she says, “but they are not weight-bearing.”
OSTEOPOROSIS RESOURCES
Are you concerned that you or someone you know may be living with osteoporosis?
To schedule an appointment with Dr. Boldo or another endocrinologist at First Physicians Group, click here.
To learn more about the Bone Builders program at HealthFit, click here.
To find more osteoporosis resources near you through the National Osteoporosis Foundation, click here.
Related Reading
Preventing Osteoporosis Through Diet & Exercise
Important Health Screenings For Women
Written by Sarasota Memorial copywriter Philip Lederer, MA, who crafts a variety of external communications for the healthcare system. SMH’s in-house wordsmith, Lederer earned his Master’s degree in Public Administration and Political Philosophy from Morehead State University, KY, and is going to start taking calcium supplements.