Osteoporosis Prevention

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.

The treatment options for osteoporosis are imperfect and all have side effects. No one  wants to take a drug by mouth or injection or intravenous infusion to prevent further bone loss if it can be avoided.  The only options to drug treatments for osteoporosis are to know your risk profile and alter it as early in life as possible.  The median age for menopause is 51. At this time the loss of estrogen accelerates bone loss. The greatest bone loss occurs is in the first 5 years after menopause. This is what every woman in her 40s should do to optimize lifelong bone health.

1. Know your risk for osteoporosis.

  1. Family history of osteoporosis, osteopenia, hip or wrist fractures, or other metabolic bone disease.
  2. Personal history of past fractures.
  3. Autoimmune or inflammatory diseases, like ulcerative colitis, Crohn’s, celiac disease, rheumatoid arthritis are associated with accelerated bone loss.
  4. Nutritional: A diet of excessive animal protein (especially in the absence of adequate plant-based food) or processed foods can increase the risk for bone loss.
  5. Metabolic: Hyperthyroidism, disordered eating, some kidney and liver diseases.
  6. Medications, including steroid use, chemotherapy, aromatase inhibitors, like femara and arimidex; proton-pump inhibitors, like Nexium or Prilosec; some anti-depressants; overuse of thyroid hormone; and some diabetes drugs, like Avandia and Actos.
  7. Having a slight build or low body weight—especially if Caucasian or Asian.
  8. Inactive lifestyle
  9. Excessive alcohol consumption (more than two drinks a day).
  10. Tobacco use either current or former smokers (though current smokers have a significantly higher risk than former smokers).

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