Education

Did you know that our bones are living tissues that grow and rebuild over time? Up until about the age of 30, people build more bone than they lose. After this age though, the rebuilding process slows and there is more bone loss than bone building. When the loss of bone becomes significant, a person has osteoporosis. Osteoporosis means “porous bone”. If you think of the interior of our bones as a honeycomb, those with low bone mass or osteoporosis have a lot more holes in the honeycomb than those with healthy bone.

 

According to the Bone Health & Osteoporosis Foundation (BHOF), 10 million Americans have osteoporosis and another 44 million have low bone mass, which means they have a greater chance of breaking bones. More women than men suffer from osteoporosis because estrogen plays a role in protecting our bone mass. It’s estimated that women can lose up to 20 percent of their bone density in the first five-to-seven years after menopause. Men get osteoporosis too, but it tends to happen later in life for the majority of them.

 

Why should you be concerned about osteoporosis?

If you want be active, mobile and independent as you age, you need to take care of your bones. If you don’t take care of your bone health, you won’t have the physical support you need to do the things you want and love to do. Some people think weakening bones is just a normal part of aging, but it isn’t. You should be able to lose a little bone mass without breaking bones. If you break a bone over the age of 50, it can have a tremendous impact on your quality of life. And it means you are at greater risk for breaking more bones, so it’s important to act now.

 

How do you know if you’re at risk for osteoporosis?

There are many risk factors for osteoporosis, some we have control over and others we don’t.

 

Age. After reaching peak bone density and strength (approximately between age 25-30), bone mass begins to naturally drop with age.

 

Gender. Women over the age of 50 have the greatest risk of developing osteoporosis. In fact, women are four times more likely than men to develop osteoporosis. 

 

Family history. Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have been diagnosed with osteoporosis or fractured a hip, you may be at greater risk of developing the disease.

 

Race. Osteoporosis effects all races, but research has shown that Caucasian and Asian women are more likely to develop osteoporosis. Additionally, hip fractures are twice as likely to occur in Caucasian women as in black women. However, women of color are more likely to die after a hip fracture.

 

Body frame. Petite and thin women have a greater risk of developing osteoporosis because they have less bone to lose than women with more body weight and larger frames. 

 

Other diseases and certain medications. Unfortunately, other diseases and the medications used to treat them can also lead to osteoporosis. Celiac disease, bowel disease, rheumatoid arthritis, eating disorders, cancer, kidney or liver disease – all increase your risk of developing osteoporosis. Extended steroid use has been shown to cause osteoporosis and medications used to treat seizures, gastric reflux, and cancer increase your risk of developing osteoporosis as well.  

 

There are things you can control to decrease your risk of osteoporosis, including:

 

Be active. Exercise strengthens the bone the same way it strengthens muscles. 

 

Eat healthy. Your bones need calcium and vitamin D and other nutrients found in a healthy diet to keep the bone structure strong.

 

Don’t smoke. Smoking increases your chance of developing osteoporosis…in addition to all the other horrible diseases it can lead to. Smoking messes with the body’s cell functioning and can prevent proper absorption of calcium.

 

Don’t drink too much. What’s too much, you say? Well, studies show that more than 2 drinks per day can have a negative impact on your body’s calcium supply. Everything in moderation!

 

What can you do to protect your bone health at menopause?

Many of the things you can do to protect your overall health also help protect your bones. Eating a healthy diet, exercising, avoiding too much alcohol and not smoking are all things that will help keep your bones strong as you age. Some of the key areas to focus on include:

 

Calcium and Vitamin D – think of these nutrients as the building blocks of strong bones. If your body doesn’t get enough of these nutrients from food, sunlight, or supplements, the body takes the nutrients from where it’s stored – mainly your bones. It’s important to try to get all of the nutrients you need from the food you eat. Yes, taking a supplement is easier, but there are more benefits to getting key nutrients from food. So…eat a well-balanced diet with plenty of fruits, vegetables, lean protein, dairy, fortified foods, and healthy fats. Only supplement when you believe you aren’t getting the recommended daily amount of nutrients from the food you eat.

 

The Bone Health & Osteoporosis Foundation (BHOF) recommends the following daily amounts of calcium and vitamin D for women at midlife:

 

Calcium for Women Age 50 and younger: 1,000 mg per day

 

Calcium for Women Age 51 and older: 1,200 mg per day

 

Weight-bearing and muscle-strengthening exercises – For bone building, you need to be on your feet and creating some “impact.” While swimming and cycling are great for cardiovascular health, they don’t do much for your bone health. Try walking, running, jumping rope, aerobics, dancing, hiking, etc., to get the weight-bearing exercise in. For muscle strengthening, try lifting small weights, yoga, Pilates, tai-chi, or other activities that help to keep your muscles strong and support your balance. One caveat – if you have osteoporosis or osteopenia (low bone mass), check with your healthcare provider about the types of exercises that are safe for you. Many of the activities that build and strengthen bones in people with healthy bones can actually break bones in people with osteoporosis and osteopenia (low bone mass). 

 

How can you find out if you’ve got osteoporosis or low bone mass?

There is a simple, non-invasive test called a bone density test, also called a dual energy x-ray absorptiometry (DXA for short), that can determine if you have osteoporosis or low bone mass. This is the only test that can diagnose osteoporosis. If you are over age 50 and have broken a bone from a fall from a standing height, you should get a bone density test. If you have more than one of the risk factors noted earlier, you should also talk with your healthcare provider about getting a baseline bone density test. Otherwise, when women reach age 65, the Medicare program includes a bone density test as part of its “welcome to Medicare” package. It’s really important to ask your healthcare provider if you’re at risk and whether or not you should have a bone density test, regardless of your age. 

 

Can osteoporosis be treated? If so, how?

The good news is that osteoporosis is treatable. There are many effective medications available that can stop the bone loss process and/or stimulate rebuilding of bone. As with all medications, there are side effects to be concerned about. However, it’s really important for you and your healthcare provider to determine if your risk of a major debilitating or deadly fracture is higher than your risk of getting a rare side effect. Keep in mind, even aspirin has side effects. Only you and your healthcare provider can decide what the best option is for your treatment. 

 

In addition to medical treatment, it’s really important to get enough calcium and vitamin D and to be active. If your body doesn’t have enough calcium and vitamin D, even medical therapies won’t work as well. And weight-bearing and muscle-strengthening exercise will help you to maintain the bone strength and density you have. 

 

 

Menopause and Bone Health: What You Need to Know from Claire Gill on Vimeo.

Heart disease is the number one killer of American women. Often women don’t know they are at risk for heart disease and/or don’t recognize when they are having a heart attack. You need to know the uncontrollable and controllable risk factor for heart disease and take steps to improve your heart health. 

 

Uncontrollable Risk Factors for Heart Disease:

 

Family history. If your father or brother had heart disease before 55, you are at higher risk of getting heart disease yourself. If your mother or sister had heart disease before 65, you are also at higher risk. If heart disease runs in your family, it may be because your family carries genes that raise your risk. Talk to your doctor about your family health history.

 

Age and menopause. Estrogen may help protect against heart disease by keeping blood vessels open and helping to maintain healthy cholesterol levels. When estrogen is lost, cholesterol can start to build up on artery walls. There is also a natural stiffening and thickening of arteries that happen with age. 

 

Race and ethnicity. African-American, American Indian and Alaska Native women are more likely to have heart disease than white, Hispanic, and Asian-American women.1 But heart disease is still the number one killer of white and African-American women.

 

Pregnancy history. Women who experience gestational high blood pressure, preeclampsia, and/or gestational diabetes all raise your risk for high blood pressure and heart disease later in life.

 

Controllable Risk Factors for Heart Disease

 

High blood pressure. High blood pressure, also called hypertension, raises your risk for heart disease. Blood pressure is the force your blood makes against your artery walls when your heart beats. If this force (pressure) is too high, it can damage your heart over time. Your risk for high blood pressure goes up as you age. High blood pressure does not usually have symptoms. The only way to know you have it is to get your blood pressure measured.

 

High cholesterol and triglycerides. In women, high triglycerides combined with low HDL cholesterol can mean a very high risk of heart disease. There are no symptoms of high cholesterol or triglycerides. The only way to know whether you have high LDL or “bad” cholesterol or triglyceride levels is to see your doctor for a blood test.

 

Overweight and obesity. The more overweight you are, the higher your risk for heart disease. The larger your body is the harder the heart has to work to pump blood throughout it. Being overweight also increases your chances of developing high blood pressure and diabetes.

 

Depression. Research has found that women 55 and younger who are depressed are twice as likely to have a heart attack or to die of heart disease as women who are not depressed. Depression also increases your risk for another heart attack if you’ve already had one. Depression can hurt your heart’s ability to beat correctly. It also can speed up the buildup of plaque in your arteries.

 

Sleep apnea. Loud snoring is often a sign of sleep apnea, a common sleep disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Sleep apnea is linked to atrial fibrillation (irregular heartbeat). Sleep apnea also may affect more than half of people with heart disease.

 

Diabetes. Diabetes greatly increases your risk for heart disease and makes it harder to survive a heart attack. Postmenopausal women who have an increase in body fat around the belly region tend to have a greater risk for diabetes and heart disease. 

 

Metabolic syndrome. Metabolic syndrome is the name for a group of risk factors that happen together and are related to your metabolism. Metabolism is the process your body uses to convert food into energy. Having metabolic syndrome doubles your risk of heart disease. You have metabolic syndrome if you have any three of these five risk factors:

 

1. Waist measurement of more than 35 inches

2. Triglyceride level greater than 150 mg/dL (milligrams per deciliter)

3. HDL cholesterol less than 50 mg/dL

4. Blood pressure of 130/85 mmHg (millimeters of mercury) or higher

5. Blood glucose greater than 110 mg/dL after fasting for at least eight hours

 

Excessive blood clotting. Excessive, or extra, blood clotting is when blood clots form too easily or break apart too slowly. Blood clots can narrow arteries and veins or block blood flow completely. This can lead to heart attack, stroke, or damage to the kidneys, lungs, or other parts of the body. Medicines with the hormone estrogen, such as hormonal birth control or menopausal hormone therapy, can raise your risk for blood clots. 

 

Behaviors that impact heart health:

 

In addition to the risk factors noted above, changes to lifestyle habits can impact your risk of heart disease. 

 

Don’t smoke. Smoking leads to heart disease. If you smoke, stop. If you don’t smoke, don’t start. The long-term effects of vaping and e-cigarettes on heart health are not known, so better to be safe than sorry and don’t do it.

 

Eat healthy. Choose a variety of foods from all food groups. Consume sweets, fats and sodium in moderation. 

 

Exercise. The heart is like all of our muscles, the more you work it, the stronger it gets. You need at least 30 minutes of physical activity five times a week to stay healthy. 

 

Avoid alcohol. More than three drinks a day can raise blood pressure and triglyceride levels and can damage your heart muscle. 

 

Try not to stress. Long-term stress raises your risk of heart disease. If you have heart disease, long-term stress also makes you more likely to have a heart attack.

 

How do you know if you’re having a heart attack?

The most common symptom of a heart attack is pain or discomfort in the center of the chest. But only half of women who have heart attacks have chest pain. Women are also more likely to have silent heart attacks. Women experience different symptoms than men. These symptoms include:

 

– Pain in the back, neck, jaw, or throat

– Indigestion

– Heartburn

– Nausea (feeling sick to the stomach)

– Vomiting

– Extreme fatigue (tiredness)

– Problems breathing (shortness of breath)

 

Women are also more likely than men to have heart attacks that do not show obvious symptoms. These are called silent heart attacks. Your doctor may discover that you had a silent heart attack days, weeks, or months later on an electrocardiogram. Women with diabetes are more likely to have silent heart attacks because diabetes can change how you sense pain.

 

What should you do if you think you’re having a heart attack?

 

If you think you’re having a heart attack, dial 911 and get emergency help right away. It’s better to call an ambulance than to try to get to a hospital yourself. The paramedics will be able to assist you with immediate help, which can be life-saving. 

 

Don’t worry about overreacting or if it turns out you did not have a heart attack. It is far better to respond to the potential symptoms of a heart attack and be wrong then to die from ignoring them. 

 

What is a stroke?

Stroke happens fast and you need to get help quickly. Stroke occurs when blood flow to a part of the brain stops or is blocked by a blood clot or plaque, and brain cells begin to die. High blood pressure and high cholesterol are two big risk factors for stroke.

 

The symptoms of a stroke come on suddenly and include:

 

– Numbness or weakness of face, arm, or leg, especially on only one side of the body

– Confusion or trouble speaking or understanding

– Trouble seeing in one or both eyes

– Trouble walking, dizziness, or loss of balance or coordination

– Severe headache with no known cause

 

Even if the symptoms go away, you should seek medical attention immediately. Sometimes you can have a “mini-stroke” and it could be a sign that you are about to have a full stroke. The sooner you get treatment for a stroke the better your chances for a full recovery. As we age, the risk of stroke increases, so the best option is to know the symptoms and be prepared to seek medical help as quickly as possible.

 

1. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/NHIS/SHS/2015_SHS_Table_A-1.pdf

Unfortunately, women tend to gain weight at midlife, even if they keep the same eating habits and exercise routine they did before menopause. It’s also harder to lose weight when you’re menopausal. The loss of estrogen at menopause can cause the shift of fat from the hips to the mid-section, which increases your risk for diabetes and heart disease.

 

Many of the other symptoms of menopause like night sweats, insomnia and mood swings can also interfere with your ability and desire to eat healthfully and exercise more.

 

How can I prevent weight gain during and after menopause?

Cutting calories and watching portion size is important. Just to maintain your current weight in your 50s, you might need to eat 200 fewer calories a day than you did in your 30s and 40s. Try not to snack too much and eat your biggest meals earlier in the day. Focus on a variety of foods from every food group – https://www.choosemyplate.gov/.

 

Exercise more and vary your workout. High intensity interval training – a combination of high intensity bursts of activity with lower intensity activities – can be a good option for staying fit at midlife. Research suggests that adults need at least 150 minutes of moderate-intensity aerobic activity every week, and two or more days a week of muscle-strengthening activities that work all of the major muscle groups, like the legs, hips, back, abdomen, chest, shoulders, and arms. If you want to lose weight, you may need to exercise more.

 

Get enough quality sleep. How much sleep a person needs to function at their optimal level depends entirely on the person. Do you thrive on five good, solid hours? Do you need eight hours of restful sleep to feel your best? Knowing how much sleep your body needs is important. As we age, we may need more sleep to help our bodies achieve the maximum benefit. It also may be harder for women to get a good night sleep due to menopausal symptoms like night sweats and incontinence. Addressing some of those symptoms may help bring on better sleep habits. Too little sleep can bring on higher levels of the body’s hunger hormone, ghrelin, and lead to weight gain.

 

Reducing stress can also help with managing your weight at midlife. Stress elevates cortisol levels, which are associated with increased abdominal fat. Reducing stress has a lot of other health benefits too, so it’s worth pursuing!

Osteoporosis Resources:

– Bone Health & Osteoporosis Foundation (BHOF)

– WebMD Osteoporosis Health Center

– U.S. Department of Health and Human Services Office of Women’s Health

 

Heart Disease and Stroke Resources:

Weight Gain and Menopause Resources:

– The Menopause Society (formerly known as North American Menopause Society /NAMS) 

– WebMD

– Mayo Clinic