Podcast Summary
Estrogen's role in bone health: Understanding estrogen's role in bone health is crucial during midlife, as it contributes to bone density and elasticity, preventing osteoporosis, a preventable condition with devastating consequences.
Estrogen plays a crucial role in maintaining bone health by preventing bone breakdown and increasing bone elasticity. Estrogen's importance goes beyond just increasing bone density; it also contributes to the elasticity of bones, which is essential for their overall strength and resilience. Unfortunately, access to estrogen therapy for women suffering from anorexia, who could benefit from it, is often a postcode lottery. As we age, it's essential to prioritize bone health, and the connection between estrogen and bone density is an essential consideration. Laura Flexer and Kuki Avery, GPs and menopause specialists, emphasize the importance of raising awareness about bone health during midlife, as osteoporosis is a preventable condition with devastating consequences. They've seen firsthand the impact of delayed treatment in their work with women struggling with anorexia and approaching menopause. So, in summary, taking care of our bones should be a priority, especially during midlife, and understanding the role estrogen plays in bone health is an essential part of that.
Osteoporosis: A Silent Killer Impacting Millions: Osteoporosis, leading to hip fractures, causes significant health issues, high costs, and even deaths. Influence bone health from a young age to maintain it during perimenopause and improve outcomes.
Osteoporosis, a condition that leads to millions of women suffering from fractures each year, can result in deaths similar to those caused by breast cancer. Yet, it often goes unnoticed and underdiscussed. Hip fractures, in particular, can lead to significant health issues and high healthcare costs, with 20-25% of patients dying within a year and 50% losing their independence. This is due to complications such as infections, blood clots, and muscle wasting. Bones are not static structures as we often assume, but living, growing parts of our body that are constantly being remodeled. Every 10 years, we have a new skeleton, and small pieces of bone are replaced every 9 months. We can influence bone health starting from a young age, with the most bone mass gained during puberty, and further gains in the following years. However, during the perimenopause, women experience rapid bone loss. It's crucial to understand the importance of bone health and take steps to maintain it, as it significantly impacts both personal and healthcare system outcomes.
Women's bones are more susceptible during developmental stages and menopause: Women are at higher risk for bone loss due to lower mass accumulation and faster elasticity loss, especially during menopause. Awareness and early intervention are key to maintaining bone health and preventing osteoporosis.
Women's bones are more susceptible to loss during key developmental stages and menopause due to lower bone mass accumulation and faster loss of bone elasticity. Estrogen plays a crucial role in both processes, making it essential for bone health. Osteoporosis, a significant health risk for midlife women, is caused by a combination of hormonal changes and general bone degradation. Awareness of risk factors and early intervention are crucial for maintaining bone health and preventing osteoporotic fractures. If a woman is at risk, healthcare professionals may recommend a Frac score assessment to determine the likelihood of a hip or major osteoporotic fracture over 10 years and guide appropriate interventions.
Assessing Osteoporosis Risk with Fracs Score: Calculate Fracs score, if over 10% get DXA scan, prevent osteoporosis with diet, lifestyle, HRT, calcium, vitamin D, balanced diet, healthy fats, assess calcium intake with Edinburgh calculator.
Women can assess their risk of developing osteoporosis through a simple Fracs score calculation, which can be done by their GP or online. If the risk is over 10%, a DXA scan is recommended to determine bone mass density and potential diagnosis of osteoporosis or osteopenia. Prevention is key, and treatment involves a holistic approach including dietary changes, lifestyle modifications, and HRT (hormone replacement therapy) for perimenopausal women. Calcium is essential for bone health, and having enough in your diet is crucial. Calcium supplementation does not increase bone density but is important to maintain adequate levels. Vitamin D, mostly obtained through sunlight exposure, is another essential nutrient for bone health. The discussion also touched upon the importance of a balanced diet, including calcium-rich foods and healthy fats, and the use of tools like the Edinburgh calcium calculator to assess calcium intake.
The Importance of Sunlight and More for Optimal Bone Health: Ensure sufficient sunlight for vitamin D production, limit phytate intake, and consider personal health history when focusing on bone health and nutrition.
Maintaining optimal bone health involves more than just consuming enough calcium and vitamin D. Sunlight is essential for producing vitamin D, and many people don't get enough, especially during winter months or if they use sunscreen regularly. Vitamin D deficiency can lead to decreased bone density. Phytates, found in plant-based foods, can interfere with the absorption of calcium and other minerals, but more research is needed to determine their impact on bone health. Women with a history of anorexia, particularly during their adolescent years, are at increased risk for developing osteoporosis due to disrupted bone development. It's crucial to consider these factors when focusing on bone health and nutrition.
Anorexia's Devastating Effects on Bone Health: Anorexia, an eating disorder, is linked to lower bone mass density and decreased peak bone mass, particularly in adolescent girls. Treatment with transdermal estrogen can help protect bones, while addressing the root cause and providing nutrition is essential.
Anorexia, a common eating disorder affecting 2-4% of women, has devastating effects on bone health, particularly in adolescent girls during their crucial bone development years. Anorexia results in a lack of estrogen and nutrients, leading to lower bone mass density and decreased peak bone mass. This condition, which has seen a rise in admissions by 84% in the last 5 years in the UK, can result in fewer than half of patients fully recovering, and up to 30% never recovering, with suicide rates being 18 times higher than the general population. To mitigate these effects, studies suggest that treating young women with anorexia with transdermal estrogen can be effective in protecting their bones for later life. While oral estrogen in the combined contraceptive pill does not effectively protect bones in this population, it is essential to address the root cause of anorexia and provide adequate nutrition. This awareness is crucial as anorexia can affect women of all ages, and its impact on bone health can last a lifetime.
Anorexic women face increased risk for osteoporosis: Anorexia can lead to bone loss and osteoporosis, even with a normal BMI later in life. Transdermal estrogen therapy could help protect bone health during this critical window of opportunity, but awareness and resources are lacking.
Women with a history of anorexia, even if they have a normal BMI later in life, are at risk for osteoporosis due to bone loss during their earlier anorexic years. This is a crucial point, especially since eating disorders are on the rise and can lead to devastating health consequences. The use of transdermal estrogen, a safe, effective, and simple treatment, could help protect bone health during this critical window of opportunity. However, there is a lack of awareness and resources for addressing bone health in eating disorder services, leaving many young women without proper care. The data shows that 90% of anorexic girls have osteopenia and 40% have osteoporosis, emphasizing the need for increased awareness and action. It's essential for individuals and families to ask about bone health when dealing with anorexia and for eating disorder charities to collaborate on this issue. Estrogen replacement therapy, which has numerous health benefits beyond bone health, could be a game-changer for these vulnerable young women.
Midlife Women: Be Aware of Relative Energy Deficiency in Sport (RED-S): Midlife women should be aware of RED-S, a condition caused by excessive exercise and restrictive eating, leading to bone and mental health issues. Symptoms can be subtle and complex, especially during menopause. Prevent it by maintaining a healthy balance between nutrition and exercise.
Excessive exercise and restrictive eating, even among midlife women focusing on their health, can lead to a condition called Relative Energy Deficiency in Sport (RED-S). This condition, recognized since 2014, occurs when the body doesn't have enough energy to support essential functions, leading to various symptoms, including bone and mental health issues. RED-S can affect both intentional and unintentional athletes, and its prevalence is significant, even among recreational athletes. Symptoms like low immunity, gut issues, and mental health changes can be subtle and challenging to distinguish from other conditions. As women age, assessing symptoms becomes more complex due to factors like menstruation and menopause. Awareness and open dialogue about maintaining a healthy balance between nutrition and exercise are crucial to prevent RED-S. While more research is needed, some believe that increasing estrogen intake may help alleviate symptoms.
Holistic approach to HRT for women's bone health: Focus on diet, increase calories, and train intensity for bone health. Estrogen, delivered transdermally, is crucial, while oral contraceptives may be detrimental. Individualized risk factors and patient choice are essential when considering HRT.
When it comes to hormone replacement therapy (HRT) for women, particularly those with a history of fragility fractures or osteopenia/osteoporosis, a holistic approach is key. This includes focusing on diet, increasing calories, and training intensity. Estrogen, delivered transdermally through patches, gels, or sprays, is crucial for bone health and the gold standard treatment. Oral contraceptives, on the other hand, can be detrimental to bones due to their synthetic estrogen and the way they are metabolized in the liver. It's essential to discuss individualized risk factors and patient choice when considering HRT, as some women may prefer oral estrogen or have better compliance with it. For younger women, starting conversations about healthy habits, such as balanced diets, regular exercise, and maintaining a healthy weight, can help prevent issues as they age.
Building strong bones: Essential for women's health: Proper nutrition, exercise, and assessments are crucial for building strong bones, especially during childhood and adolescence. Hormone therapy and promising treatments like psilocybin offer hope for women with anorexia.
The development of strong bones is crucial, especially during the early years of a child's life. Proper nutrition and exercise are essential for building high peak bone mass by the age of 25 to 30. For mothers of daughters with anorexia, it's essential to prioritize bone health assessments and treatments. Even for women in midlife, it's never too late to focus on bone health. Simple measures like good nutrition, weight-bearing exercise, and muscle strength can make a difference. Hormone replacement therapy, particularly estrogen, can also be beneficial for women experiencing bone loss during perimenopause. The future of eating disorder treatments is promising, with research into the use of psychedelics like psilocybin showing positive results in helping individuals with anorexia change their mindset.
Promising neuroplasticity for anorexia treatment: Neuroplasticity offers hope for anorexic patients, but more resources are needed for psychological support in primary care. Perimenopause may trigger disordered eating relapses, requiring further research.
Neuroplasticity, the brain's ability to build and recognize new connections, holds promise for helping anorexic patients develop healthier perceptions of eating. However, more resources are needed to provide crucial psychological input for women suffering from anorexia in primary care. Additionally, the connection between hormonal changes during perimenopause and potential relapses of disordered eating warrants further research. Overall, increasing awareness and resources for addressing eating disorders in women, especially during perimenopause, is essential.
Exploring Menopause, Oestrogen, and Bone Health with the Lazar Well-being Show: Learn about menopause, oestrogen, bone health, and more from the Lazar Well-being Show. Access ad-free listening with Lazar Well-being Show Plus. Celebrate Mother's Day with special offers from 1-800-Flowers. Get flexible short-term health insurance plans from UnitedHealthcare. Don't forget to check out LazarWellbeing.com for more resources.
There are various resources available for learning about menopause, oestrogen, bone health, and more, including the Lazar Well-being Show and its free weekly newsletter. For those interested in ad-free listening, the Lazar Well-being Show Plus is also available on Apple Podcasts for a small fee. This Mother's Day, consider giving back to the moms in your life with special offers from 1-800-Flowers. And, for those in need of short-term health insurance, UnitedHealthcare offers flexible plans with nationwide coverage. A final interesting fact, a crocodile cannot stick out its tongue. Remember to check out LazarWellbeing.com for more information and resources.
