Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

by Patricia Yarberry Allen, MD | bio


Now listen: The last thing you want to deal with in the glorious New Menopause is brittle bones. The good news? You don’t have to.

Most of us can actually improve bone density without drugs by taking some common sense steps, along with a few less obvious strategies:

1. Cut alcohol consumption. We already know that drinking more than three half-glasses of wine a week is associated with an increase in breast cancer, obesity and many other health problems for women. But alcohol is also associated with increased bone loss and decreased calcium absorption.

2. Eat! Yes, you can be too thin. Women who are underweight have fewer pounds to add the all important stress to the skeleton than stimulates new bone growth. In addition, women who are underweight often have a diet that is deficient in many of the nutrients and minerals that support healthy bone growth.

3. Cut out the salt. It increases the excretion of calcium. Not what you want to do with all that hard-earned calcium you are ingesting. Besides, excess calcium excretion can increase your risk for kidney stones.

4. Develop a bone-building exercise program. It’s best to do this in consultation with a physical therapist, or to work with an experienced and mature personal trainer who understands the way to safely develop an individualized program that builds on strengths and avoids weaknesses.

You don’t want strain and injuries. Learn how to warm up and cool down. Learn the best stretching exercises for your body. If you develop discomfort when you exercise without the physical therapist or trainer, you can consult with them to avoid musculoskeletal harm.

Once you have learned what you can do safely based on your overall health and current fitness level, begin slowly to do weight-bearing and strengthening exercises. These include walking both outside and on a treadmill, cycling and using some gym equipment that forces you to use your own body weight to stimulate the bones to become stronger.

You should start slowly but do one of these exercises every single day unless you have discomfort. Then push yourself based on your health and tolerance to walk longer and faster.

Strengthening exercises involve using small weights and resistance bands to build muscle. Once again, this is best done with a trainer to avoid injury until you are comfortable with the routine. Weight lifting should only be done two or three times a week.

5. Find a buddy. Or, even better, a group of women who are interested in improving both their bone health and their overall health to support each other. Start the group! It is much easier to get up and get out every day when you know that you are not only giving yourself the gift of Bone Building Without Drugs, but you are also making a difference in the lives of others. Everyone is much more likely to do the work daily if they have someone to urge them on.

6. Increase daily activity. Move, move, move! Find a way to add increased activity to your daily chores and routine. Climb stairs, get off a mile before a bus or subway stop and walk the rest of the way, and add activities that require some physical work — such as gardening, walking the dog, walking to the post office, walking to visit a friend.

7. Increase calcium and vitamin D from both dietary and supplement sources. If your blood calcium levels are normal and you’ve never had a kidney stone, discuss taking a form of calcium product with your doctor.

8. Limit the phosphate in your diet. Read labels! The mineral phosphorus found in lots of foods is important in small amounts for healthy bone development. But it causes real problems in the high levels of phosphate additives found in the American diet. Processed foods and soft drinks have high levels of phosphates. This mineral interferes with calcium absorption.

9. Take a daily magnesium supplement. This mineral supplement is necessary for bone building and may decrease the constipation that some patients have when they begin calcium. If you find that the calcium supplement you have chosen is causing or worsening pre-existing constipation, take a break from the supplements and get the colon function in its best shape.

Increase fiber from dietary sources such as Fiber One Cereal with Activa Yogurt and two tablespoons of ground flax seed in this breakfast cereal mix every morning. Add Colace, a stool softener (not a stimulant laxative) one to three times a day. Drink 32 ounces of water a day. Avoid foods that cause constipation, such as pasta and breads. Eat steamed or dried prunes for a snack every afternoon. Once the bowel function has improved, introduce the calcium supplements slowly and always take the magnesium. Don’t just stop the calcium because of constipation.

10. Finally, the most important thing here is that you must not lie to yourself. If you are really committed to improving bone health without drug therapy, then you must commit to a new way of living: calcium and vitamin D; dietary modifications to take out the bad and add the good; a daily exercise program that you approach as seriously as taking a drug.

After 18 months, repeat your bone density test. If it is stable, then stay the course.  If it is worse, then it is time for a work-up to decide what medical treatment is right for you.

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  • BARBARA THORNBROUGH June 30, 2008 at 9:34 am

    HOW INTERESTING ABOUT THE SALT TAKING CALCIUM OUT OF THE BODY. I DID NOT KNOW THIS AND FOUND IT A GREAT FACTOID. THANK YOU DR. ALLEN.
    BARBARA THORNBROUGH

    Reply
  • Wendy Lawson May 6, 2008 at 1:07 am

    This is good information and very timely. There have been a number of research studies examining the connection between biphosphonates (Boniva, Fosamax, Actonel) and jaw pain, bone pain and irregular heartbeats. (I’ve summarized the findings and provided links on http://www.menopausetheblog.com) It’s good to know that there are alternatives to taking these drugs.

    Reply