A Healthier, More Satisfying Second Half of Life: Bone Health

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.

This is the eighth in our series (40 Things for Every Woman in Her 40s) of Medical Monday articles intended to be useful to all our readers, but pointed especially toward those in their 40s—that in-between decade in which hormonal change has begun but fertility is still possible. Our first article focused on self-care; our second emphasized the need to pay attention to psychological issues; the third provided tips on preventing and repairing skin damage; the fourth focused on “exercise as medicine”; the fifth topic was on sexual intimacy. In the sixth, Dr. Megan Riddle wrote about actions to reduce stress and improve mood. Most recently, in the seventh of the series, Dr. Patricia Yarberry Allen focused attention on the brain and offered four key strategies to protect and improve cognitive function. 

This week the focus is on musculoskeletal health from Dr. Sonal Parr and Dr. James Wyss. —Ed.



Bone Health Begins at 40
By Dr. Sonal Parr (read bio on our Medical Advisory Board)


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). READ MORE

Next Page: How you can affect future bone health.

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  • D. A. Wolf January 19, 2016 at 2:03 pm

    This kind of article is extremely helpful and I only wish I had been more aware of these factors when I was in my 40s. I thought I knew about all of the risk factors only to find that item – having a slight build or being petite – is one that I would not have anticipated. Color me surprised when my physician pointed out my increased risk because of my diminutive stature (barely 5′), along with other factors.

    One of the other items on this list, the issue of weight-bearing exercise, reminds me of a question that has gone unanswered for years: What if you have sustained injuries that don’t allow for weight bearing exercise? What alternatives might one have? Or if you live with chronic pain, what are some of the alternatives if weight bearing exercise is not possible?