Podcast Summary
Careers in Women's Health: Unexpected Turns and Passions Discovered: Both Dr. Newson and Dr. DeSappri have had diverse careers in women's health, starting with traditional paths but taking unexpected turns based on personal interests and patient experiences. They emphasize the importance of staying curious and adaptable, making a positive impact on women's health throughout their lives.
Key takeaway from this podcast episode is that both Dr. Louise Newson and her guest, Dr. Kristi DeSappri, have had diverse careers in women's health, which started with traditional paths but took unexpected turns based on personal interests and patient experiences. Dr. Newson shares her passion for running a menopause clinic and founding the Menopause Charity and the Menopause Support App, while Dr. DeSappri discusses her journey from wanting to be an OBGYN to focusing on internal medicine and a fellowship in multidisciplinary women's healthcare, leading to a specialization in bone health. They both emphasize the importance of staying curious and adaptable in their careers and making a positive impact on women's health throughout their lives.
Understanding Osteoporosis and Women's Bone Health: Osteoporosis is under-diagnosed, with only 25% of women getting bone density tests after 65, despite its importance for preventing fractures. Hormones, nutrition, and exercise all play roles in maintaining bone health.
Osteoporosis and bone health are crucial aspects of women's health, particularly during midlife, that are often overlooked. Osteoporosis is an under-diagnosed condition, with less than 25% of women in the US getting bone density tests after the age of 65, despite recommendations for universal screening. This disease, which involves low bone mass and can lead to fractures, is often considered a hidden issue because many people don't realize the severity of bone fractures, especially in older adults. Our bones are not just static structures but are metabolically active, with cells constantly building and breaking down bone. Hormones like estrogen and parathyroid play significant roles in bone health. Preventing osteoporosis and its fractures is essential, as hip fractures, for instance, can have serious consequences for older adults. It's crucial to recognize the importance of bone health and take steps to maintain bone density through proper nutrition, exercise, and regular screenings.
Understanding Osteoporosis: A Common Condition Affecting Millions: Osteoporosis is a condition that affects millions, particularly women over 50, leading to bone loss and increased fracture risk. Clinical risk factors include being female, reaching menopause, and having a family history of fractures. The FRAC score assesses these risks.
Our bones are constantly remodeling, but this process slows down as we age, increasing the risk for osteoporosis. Osteoporosis is a common condition, particularly in women over the age of 50, with around one in two women and one in five men being affected. The condition results in loss of skeletal mass and increased risk for fractures. It's important to note that more women have hip fractures than breast, uterine, and ovarian cancer combined. Clinical risk factors for osteoporosis include being female, reaching menopause, and having a family history of fractures, among others. The FRAC score is a tool used to assess clinical risk factors, including age, height, weight, and medication use. Overall, osteoporosis is a significant condition that warrants attention, and it's essential to be aware of the risks and available resources for prevention and treatment.
Assessing bone health regularly is essential: Regular bone health assessments, particularly around age 45-55, using DEXA scans can help identify osteoporosis or osteopenia, prevent fractures, and address risk factors early.
Regular bone health assessments, particularly around the age of 45 to 55, are crucial for both men and women. While cholesterol levels are commonly measured, a DEXA scan is the gold standard for assessing bone density and identifying potential issues like osteoporosis or osteopenia. These conditions may not always be indicated by other risk factors, making early detection vital. Prevention is key, as treating fractures after they occur is far more costly and complex than making lifestyle adjustments when healthy. It's essential to consider individual risk factors, such as family history, nutrient intake, exercise habits, and calcium intake during critical bone growth years. The interplay of these factors can significantly impact bone health. Regular assessments and addressing potential risk factors early can help maintain bone health and reduce the risk of fractures.
Factors influencing women's bone health: Understanding genetics, ethnicity, hormonal changes, and lifestyle factors can help women maintain bone health. Regular screening and lifestyle modifications are key to prevention.
Women's bone health is influenced by various factors including genetics, ethnicity, hormonal changes, and lifestyle factors. Women who undergo premature menopause due to conditions like hereditary breast and ovarian cancers or idiopathic osteoporosis are at a higher risk for bone density loss. Hormones, particularly estrogen and testosterone, play a crucial role in maintaining bone health. The loss of estrogen during menopause disrupts the balance between bone formation and bone breakdown, leading to bone loss. DEXA scans, a simple, low-radiation test, can provide valuable information about bone health. Preventative strategies include awareness, regular screening, and lifestyle modifications. Ethnicity and genetics can impact bone density, and individualized approaches may be necessary for effective treatment.
Significant bone density loss during menopause, particularly in trabecular compartments: Women may lose up to 20% in trabecular bone and 5-7% in cortical bone during menopause. HRT can help restore hormonal imbalance, stimulate bone building, and reduce fracture risk.
During menopause, women experience significant bone density loss in the trabecular compartments, leading to an imbalance in bone mineral density losses in the spine. This loss can amount to up to 20% in trabecular bone and 5-7% in cortical bone. Women with a family history of osteoporosis or those experiencing perimenopause for longer durations may experience even greater bone density loss. Estrogen replacement therapy (HRT) can help restore the hormonal imbalance and potentially stimulate bone building, as shown in animal studies and bone biopsies. Despite this, many women with osteoporosis are not prescribed HRT, and guidelines often caution against it due to unfounded concerns about heart attacks, breast cancer, and other side effects. However, studies have shown that HRT reduces the risk of hip, vertebral, and non-vertebral fractures in women around the age of 60. HRT offers additional benefits for heart, brain health, and symptom relief, making it a preferred choice for managing osteoporosis over bisphosphonates, which have finite treatment durations and side effects.
Hormone therapy reduces risk of fractures for women in their 50s and beyond: Hormone therapy can prevent bone resorption and reduce fracture risk, particularly for vertebral, non-vertebral, and hip fractures. However, decisions should be based on individual risks and benefits, considering hormones make bones more flexible and bisphosphonates can make bones denser but brittle.
Hormone therapy for women during their 50s and beyond can still offer a significant reduction in the risk of fractures, particularly for vertebral, non-vertebral, and hip fractures. This benefit extends beyond menopause and into older age. However, the decision to use hormone therapy or other treatments like bisphosphonates should be based on individual risks and benefits. Both hormones and bisphosphonates work by preventing bone resorption and filling in active resorption cavities, but they have different effects on bone structure. Hormones make bones more flexible and less likely to fracture, while bisphosphonates can make bones denser but more brittle. It's essential for patients to be informed and empowered to make the best choice for their unique situation. Additionally, healthcare providers should move beyond a one-size-fits-all approach and consider the risks and benefits throughout a woman's lifespan.
Estrogen therapy benefits for bone health in older women: Older women can prevent bone loss and alleviate menopause symptoms with estrogen therapy. Transdermal estrogen is a safe option, and even low doses can help protect bones and reduce joint pain. Personalized treatment plans allow for effective and safe use.
While there are limitations and risks associated with the use of estrogen therapy (HRT) for bone health, particularly in the long-term, it still offers benefits, especially when started in older women and used in appropriate doses. Estrogen plays a crucial role in maintaining bone health, muscle strength, and joint health. Transdermal estrogen, which has no risk of blood clots, is a safe and effective option for older women to prevent bone loss and alleviate symptoms of menopause. Studies suggest that even low doses of estrogen can help protect bones and reduce joint pain. The availability of various estrogen and progestogen doses and delivery methods allows for personalized treatment plans. For instance, low-dose patches can offset bone loss in women with low bone density. It's important to note that standard doses of estrogen closer to the time of menopause are more effective for bone health. However, individual intolerances and concerns must be considered when prescribing HRT.
Menopause and Bone Health: Menopause increases risk of osteoporosis due to hormonal changes. DEXA scan and discussion with a clinician are recommended for individual risk assessment. Consider hormone therapy for bone health benefits if no contraindications.
Menopause is a critical time for women's bone health. Hormonal changes during this stage can impact bone density, increasing the risk of osteoporosis. Awareness of individual risk and bone mineral density is crucial. Obtaining a DEXA scan and discussing the results with a women's health clinician is recommended. Additionally, starting hormone therapy earlier in the menopause transition may not only improve symptoms but also enhance bone health benefits. It's essential to consider hormone therapy as an option for bone health management if there are no contraindications. Remember, bone health is just one aspect of women's overall wellbeing during menopause, which also includes cardiovascular, cognitive, and joint health. Women should advocate for themselves, educate themselves, and seek professional advice to maintain their independence and overall wellbeing.
Educate yourself and ask questions for informed bone health decisions during perimenopause and menopause: Seeking knowledge and advice from healthcare providers is crucial during perimenopause and menopause for making informed decisions about bone health. Don't hesitate to advocate for yourself and seek a second opinion if needed.
Seeking knowledge and advice from healthcare providers during perimenopause and menopause is crucial for making informed decisions about bone health. It's important to educate yourself and ask questions to ensure you receive accurate information. If you don't feel comfortable with the information provided by one healthcare professional, don't hesitate to seek a second opinion. Chris Newson emphasized the significance of this advice, and the importance of advocating for yourself in your healthcare journey. He also highlighted the importance of education for both women and men regarding bone health during these stages of life. For more information and resources, visit balance-menopause.com or download the free Balance app from the App Store or Google Play.
