How I’m working on stopping osteopenia in its tracks
Jules Walters • First published: Apr 24, 2023
I have always tried to keep healthy, so it was a shock 18 months ago to discover I had osteopenia in my lower spine. I’d decided to have a routine DEXA imaging scan and discovered that my score for bone mineral density was in the range of osteopenia.
Living with osteopenia is like being in the waiting room for osteoporosis, a condition where bones are so weakened they can easily break. It was time to get to work on my bones.
I’ve always exercised, been careful of what I eat and have no problem sleeping. There are 101 ideas we can do to stay healthy. But, as I’m learning, that’s not enough to keep osteopenia at bay.
And I’m not alone. Over half of women will develop osteopenia post menopause.
Step 1: Topping up my calcium
Research estimates that we’re losing around two per cent of our bone mass each year after menopause. That’s a lot. By the time we finish menopause, we could have lost up to 20% of our bones!
So what’s to do?
First, my primary care doctor recommended I look at taking a calcium supplement. So, I did my research – and the Bone Health and Osteoporosis Foundation recommends 1,200 mg of calcium a day for women aged 50 and older.
I calculated I could get half my daily calcium needs through food; especially from dairy products like yogurt and cheese, and canned fish like sardines.
I put those on the menu and started on a good calcium supplement including vitamin D and K to make sure the calcium got out of my blood and into my bones.
Then, I supplemented calcium for 18 months and went back for another DEXA scan. I expected the results to be positive. I’d done the work, so now my bones should have strengthened. Right?
Wrong. My scan results were much the same, maybe a little worse.
Step 2: Work on my estrogen
OK. In my case, calcium on its own was not enough. So, now I’m adding a second step: boosting my estrogen.
Up until menopause, we produce three estrogen hormones naturally. They have a protective effect on our bones, by promoting the activity of cells that make new bones.
So, now I’m topping up my estrogen levels through a topical cream that includes estrogen with another female hormone, progesterone. Studies have shown that this method of delivering estrogen made a three to four per cent improvement in bone mineral density.
Let’s see how that goes. As I’m learning: prevention is personal. My doctor can guide and advise, but I need to be aware of my health data and suggest actions based on the results.
How can I get a DEXA scan?
Thankfully, we now have modern tools like a DEXA scan that can give us a baseline reading as to where we are in terms of bone density.
If you’re in the US, your primary care can order a scan, and most insurers will cover a scan every two years. In the UK, NHS guidance is that DEXA scans are for people over 50 with a risk of developing osteoporosis. Given the data, I’d say that’s every woman. So: please talk to your doctor about getting one.
It’s a similar procedure in Australia: your GP can refer you for a scan. It’s painless and only takes 10-15 minutes. So please get scanning!
Why doesn’t my doctor mention bone loss?
I’ve written on this topic before. As a society, we’re used to putting our health in our doctors’ hands. But doctors are trained to treat sickness. Wellness is up to us.
If you want to dig more into the subject of bone thinning and the options open to you, I found this helpful summary from The North American Menopause Society.
How can I get a DEXA scan?
Thankfully, we now have modern tools like a DEXA scan that can give us a baseline reading as to where we are in terms of bone density.
If you’re in the US, your primary care can order a scan, and most insurers will cover a scan every two years. In the UK, NHS guidance is that DEXA scans are for people over 50 with a risk of developing osteoporosis. Given the data, I’d say that’s every woman. So: please talk to your doctor about getting one.
It’s a similar procedure in Australia: your GP can refer you for a scan. It’s painless and only takes 10-15 minutes. So please get scanning!