Osteoporosis and Bone Health for Women

Osteoporosis is a chronic disease that causes bone tissue loss and weakness, which can lead to painful fractures in the spine, hip, wrist or other bones. While osteoporosis can develop in anyone, the risk for women is up to five times greater than it is for men.

Studies estimate that 50% of women age 50 and older will suffer a broken bone due to osteoporosis. Managing the health impact of osteoporosis can be challenging and lead to significant decline in quality of life.

Osteoporosis Prevention and Treatment for Women

With effective care, it’s possible to improve bone health, lower your risk and even prevent fractures. At the Center for Women’s Integrated Health, this is our goal for patients who have or are prone to developing osteoporosis. Our specialists create prevention and treatment plans unique to your personal risk factors, symptoms and health history.

We don’t think of osteoporosis as just a bone disease. Our approach involves a team of specialists — including endocrinologists, primary care providers, gynecologists, orthopaedists and others — working together to effectively address osteoporosis as a part of your total health and wellness.

Osteoporosis, Estrogen and Aging

Why is osteoporosis more common in women?

Osteoporosis is more common in women due to hormonal changes, and also because women tend to have thinner body frames.

Estrogen and other hormones play important roles in how the body builds bone tissue. As estrogen levels fall during menopause, your bones may become weaker and your risk for osteoporosis increases. This is why osteoporosis is so common after menopause.

Both men and women with thinner body frames have higher risk for osteoporosis, but thinner body frames are more common in women.

Osteoporosis is also more common in:

White, Asian or Mexican people
People with a family history of osteoporosis and bone fractures
People with medical conditions that increase risk for faster bone loss, such as autoimmune or digestive diseases
People with a history of eating disorders or very low body weight, leading to loss of menstruation in their teens or early twenties

At what age should women have a bone density test?

Guidelines generally recommend a bone density test by age 65 for women, possibly sooner if you have certain signs, symptoms or risk factors, such as:

Family history of osteoporosis or bone fractures
Back pain caused by a collapsed vertebra
Hunched or stooped posture (kyphosis)
Bone fracture from a low-force impact or movement
Early menopause

Screening for osteoporosis starts with a personal evaluation, including a detailed review of your medical history and a physical exam performed by your doctor. Based on your history, physical exam and fracture risk factors, additional laboratory tests and imaging may be necessary.

If you’re concerned, talk with your doctor about whether you should have a bone density test.

Does low estrogen cause osteoporosis?

What causes osteoporosis in older women?

Osteoporosis is more common in older women due to increased bone loss with age and lower estrogen levels after menopause. Lower estrogen levels after menopause can weaken bone tissue and cause osteoporosis. It is estimated that half of women over the age of 50 will have an osteoporosis-related fracture in their lifetime.

Healthy bone tissue constantly breaks down and grows back. Through early adulthood, the human body generally replaces bone tissue at the same rate or faster than it breaks down. Usually between ages 30 and 40, the rate of bone growth starts to gradually slow down in the female body. Eventually, your body loses bone tissue faster than it can replace it, leading to thinner bones (lower bone density) and higher risk for osteoporosis and fractures.

What can women do to prevent and treat osteoporosis?

Osteoporosis prevention and treatment can involve behavior changes, medication, alternative medicine and surgery. A key benefit of our integrated approach is having a team of specialists with different areas of expertise thinking about your care plan, including potential medication side effects and complex health concerns unique to you.

Even if you’re not having symptoms, it’s never too early to think about osteoporosis prevention — especially for women and other people with common risk factors.

Nutrition, Exercise and Lifestyle Behaviors

Everyday behaviors and choices have an impact on bone health, sometimes playing an important role in osteoporosis prevention and treatment.

Our specialists in primary care, lifestyle medicine, alternative medicine and physical therapy can help you:

Maintain a well-balanced diet with foods rich in calcium, vitamin D and other nutrients that are good for bone health, including supplements if necessary
Learning fall prevention techniques, including avoiding activities that increase risk for falls
Get regular exercise, including techniques to strengthen your bones, such as:
- Walking
- Running
- Dancing
- Activities to improve balance and core strength, such as weight lifting, Pilates, yoga or tai chi
Quit smoking, limit alcohol intake and manage substance abuse

Medication and Hormone Therapy

Your doctor will work with you to determine the best medication — or combination of medications — based your unique factors, such as overall health status, fracture risk, level of bone density and personal preference.

Osteoporosis treatment can involve drugs to either slow the rate of bone tissue breakdown or drugs to grow and strengthen bone tissue.

This may include:

Drugs that block bone resorption (bone break down), such as bisphosphonates or denosumab
Drugs that build new bone, such as teriparatide, abaloparatide and romozosumab

Hormone therapy (HRT) can also be an option for some patients, because estrogen can help improve bone density. However, it depends on important personal considerations, such as whether the patient:

Is premenopausal, currently in perimenopause or menopause, or postmenopausal
Has additional health concerns that could be affected by hormonal changes
Is currently taking other medications with side effects that could cause complications

Surgery for Spinal Fractures

Meet Our Osteoporosis and Bone Health Physician Team

In addition to our physician team, board-certified physician assistant Megan McCaleb, MMS, PA-C, provides evidence-based care and patient education for osteoporosis treatment and prevention. She specializes in benign gynecology and bone health.

Laura Dickens, MD

Endocrinology

Rajesh K. Jain, MD

Endocrinology

Jennifer M. Rusiecki, MD

Internal Medicine

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