The Truth About Osteoporosis: Why Women Should Prioritise Their Bone Health Now
When we think about our health, our bones often take a back seat to other priorities. Yet, for women, maintaining strong and healthy bones is crucial at every stage of life. Osteoporosis—a condition that weakens bones and increases the risk of fractures—is often seen as something that only affects older women. But the truth is, the foundations of good bone health are laid early on, and poor habits in your younger years can have a lasting impact.
If you’re a young, active woman, a new mum, or approaching menopause, it's time to pay attention to your bone health. Here’s why—and how—you can protect your bones at every stage of life.
Osteopenia is a condition characterised by lower-than-normal bone mineral density, serving as a potential precursor to osteoporosis. While it does not yet involve the severe weakening of bones seen in osteoporosis, osteopenia signifies that bones have started losing density and strength, increasing the risk of fractures over time. This condition is often a wake-up call, highlighting the need to adopt preventive measures to safeguard bone health. Lifestyle factors such as inadequate calcium intake, lack of weight-bearing exercise, and certain medical conditions can contribute to the development of osteopenia. Identifying and addressing these factors early can help slow the progression and reduce the likelihood of osteoporosis later in life.
Methods for Diagnosing Osteopenia and Osteoporosis
Diagnosing osteopenia and osteoporosis typically involves assessing bone density through a dual-energy X-ray absorptiometry (DEXA) scan. This non-invasive test measures bone mineral density (BMD) and provides a T-score, which compares an individual's bone density to that of a healthy young adult. A T-score between -1.0 and -2.5 indicates osteopenia, showing lower-than-normal bone density but not severe enough to be classified as osteoporosis. Doctors may also review the patient’s medical history, including risk factors such as family history, lifestyle habits, and previous fractures. Blood tests may sometimes be conducted to rule out underlying conditions, such as vitamin D or calcium deficiencies, that could impact bone health. Early and accurate diagnosis is essential for developing a targeted treatment plan to protect and maintain bone strength.
Why Women Are at Higher Risk for Bone Issues
Women are at a greater risk of developing osteoporosis compared to men due to a combination of hormonal changes, lifestyle factors, and nutrition. Estrogen—a hormone crucial for maintaining bone density—begins to decline in women during menopause, which accelerates bone loss. However, lifestyle factors, such as inadequate nutrition and over-exercising earlier in life, can also set the stage for weakened bones in later years.
Understanding how science plays a role in bone health can help us make better choices now.
The Science of Bone Health
Our bones are dynamic structures. They are constantly being broken down and rebuilt in a process called remodelling. During our childhood and teenage years, bones grow rapidly, peaking in density by our early 20s. From there, bone mass slowly begins to decline.
How nutrition and exercise play a role:
Calcium and Vitamin D: Calcium is the building block of bone, while vitamin D helps our bodies absorb calcium. If either is lacking in your diet, bone density can be compromised.
Exercise: Weight-bearing and resistance exercises signal your body to build and maintain bone strength.
Energy Balance: When “energy in” (calories from food) doesn’t match “energy out” (calories burned during exercise and daily activities), your body may stop producing adequate estrogen, leading to a condition called “relative energy deficiency in sport” (RED-S) that negatively impacts bones.
Now, let's break down how women at different life stages can look after their bones.
For Younger Women and Female Athletes
Many young women believe they’re too young to worry about osteoporosis. However, behaviours in your twenties and early thirties play a critical role in setting the foundation for long-term bone health.
Younger women and female athletes, though generally considered at a lower risk for osteoporosis, may still face increased susceptibility to bone injuries such as stress fractures. Many factors contribute to this risk, including osteopenia—the early stage of bone loss—and, in more severe cases, osteoporosis. Stress fractures, common in this group, often occur in weight-bearing bones like the tibia (shinbone) or metatarsals (foot bones), frequently due to repetitive impact or overtraining. Avulsion fractures, where a small piece of bone is pulled away by tension from a tendon or ligament, can also result from sudden, forceful movements. Additionally, falls or collisions can lead to wrist and ankle fractures.
One crucial contributor to these issues is Relative Energy Deficiency in Sport (RED-S), a condition where energy intake fails to meet the demands of physical activity. This energy imbalance can disrupt hormonal functioning, reduce bone density, and impair recovery, significantly increasing the likelihood of fractures over time. Addressing factors like proper nutrition (high in calcium and vitamin D), maintaining balanced training regimens, and recognising early signs of discomfort is essential for reducing injury risks and supporting long-term bone health in young female athletes.
Common Risks:
Over-Exercising Without Enough Fuel: Female athletes and fitness enthusiasts often risk energy imbalances by pushing their bodies hard without eating enough.
Skipping Important Nutrients: Diet trends and restrictive eating plans can cut out essential nutrients like calcium and vitamin D.
Strategies for Strong Bones:
Optimise Nutrition: Prioritise calcium-rich foods such as dairy products, leafy greens, and fortified foods. Don’t forget about vitamin D, which can be sourced from fatty fish, egg yolks, and sunlight.
Focus on Energy Balance: Ensure you’re eating enough to support your basal metabolic rate (BMR) and your activity levels. Consult a nutritionist if you’re unsure.
Exercise Smarter: Include weight-bearing activities like running, dancing, or resistance training in your routine. Avoid overtraining—recovery is equally important.Osteopenia is a condition where bone mineral density is lower than normal, but not low enough to be classified as osteoporosis. While it is more common in older adults, younger women can also develop osteopenia. This can result from factors such as inadequate calcium and vitamin D intake, eating disorders, hormonal imbalances, or excessive exercise without proper nutrition. Women with osteopenia may have weaker bones, increasing their risk of fractures, especially in areas like the wrists, hips, and spine. Early diagnosis and lifestyle changes are crucial to prevent the progression to osteoporosis and to maintain overall bone health.
For Breastfeeding Mums
Motherhood is a beautiful stage of life, but it can take a toll on your bone health. Breastfeeding can temporarily reduce calcium in your body, as calcium is drawn from your bones to support milk production.
Breastfeeding mothers with osteopenic bones are more susceptible to certain types of fractures due to reduced bone density. Common fracture sites include the spine, which may lead to painful vertebral compression fractures, and the hips, where fractures can significantly impact mobility and quality of life. Wrist fractures are also prevalent, often resulting from falls due to weakened bones unable to absorb impact effectively. These fractures not only cause discomfort but may also challenge a mother's ability to care for her child during the healing process. Early prevention and intervention are essential to minimise these risks.
Common Risks:
Calcium Depletion: Prolonged breastfeeding without proper calcium intake can contribute to bone density loss.
Exhaustion: Fatigue from sleepless nights can lead to neglect of self-care, including diet and exercise.
Strategies for Strong Bones:
Boost Your Calcium Intake: Aim for 1200 mg of calcium daily. Include cheese, yoghurt, almond milk, and even canned fish like salmon or sardines with bones.
Supplement If Needed: If you’re not getting enough vitamin D from sunlight or food, a supplement may help.
Light Exercise: Gentle weight-bearing exercise like walking or yoga can help maintain bone strength postpartum.
Prioritise Rest and Recovery: Fatigue isn’t just about feeling tired—it affects your body’s ability to regenerate and repair. Make rest a non-negotiable.
For Women in Peri- and Post-Menopause
Menopause brings significant hormonal changes, particularly the drop in oestrogen that accelerates bone loss. Post-menopausal women can lose up to 20% of their bone density in the first 5–7 years after menopause.
Women in peri- and post-menopausal stages are particularly vulnerable to osteoporotic fractures due to declining bone density. The most common types of fractures experienced in this age group are vertebral fractures, hip fractures, and wrist fractures. Vertebral fractures can lead to significant pain, posture issues, and reduced lung capacity, while hip fractures often result in profound impacts on mobility and independence, with many individuals requiring long-term care. Wrist fractures, though typically less debilitating, can still cause notable limitations in daily activities.
Impact of Osteoporotic Fractures on Mobility and Mortality
The consequences of these fractures extend beyond physical discomfort. Statistically, around 50% of women who suffer a hip fracture will lose their ability to walk independently, a major blow to their quality of life. Even more concerning, 20% of women over the age of 50 who experience a hip fracture die within a year as a result of complications like infections, blood clots, or other conditions exacerbated by reduced mobility. These figures highlight the critical importance of prevention and proactive measures to maintain bone health in this demographic.
Common Risks:
Bone Fragility: Lower bone density increases the risk of fractures, particularly in the hips, spine, and wrists.
Sedentary Lifestyle: A lack of exercise can exacerbate bone loss.
Strategies for Strong Bones:
Strength Training: Incorporate resistance exercises to maintain muscle mass, which supports bone strength.
Bone-Healthy Foods: Eat a diet rich in calcium, vitamin D, and magnesium. Include foods like dairy, nuts, seeds, and green vegetables.
Consider Bone Health Assessments: A DEXA scan can measure your bone density and provide insight into your risks.
Discuss Hormone Therapy: Hormone replacement therapy (HRT) may be an option to slow bone loss. Consult your doctor.
The Importance of Recovery and Self-Care
One overlooked aspect of bone health is recovery. Whether you’re a young athlete, a busy mum, or a woman navigating menopause, stress and overwork can negatively impact your bones. Sleep and recovery allow your body to rebuild—making them just as important as exercise and diet.
Some bonus tips:
Get Outside: Sunshine boosts vitamin D levels naturally.
Limit Alcohol and Smoking: Both can reduce bone density over time.
Regular Check-Ups: Monitor your bone health with regular medical check-ups, especially if you have risk factors for osteoporosis.
Strong bones aren't a given—they're something you build and maintain throughout your life. Whether you’re in your twenties or your sixties, prioritising bone health is an investment in your future mobility, independence, and overall well-being.
If you start implementing these strategies today, you can significantly reduce your risk of developing osteoporosis later in life. It’s never too early—or too late—to protect your bones.
Don’t wait until it’s too late to prioritise your well-being. If you would like to develop a personalised strategy that supports not just your bone health, but your whole health, I would love for you to get in touch with me. Through tailored lifestyle interventions, we can work together to build a healthier, stronger skeletal system.