Menopausal Osteoporosis: Getting down to the bare bones
If you are a female-bodied individual dealing with menopause, chances are you have had a conversation with your doctor about bone loss and osteoporosis. If you haven’t, consider this article the beginning of that conversation. Loss of bone density is one of the most common health issues facing all individuals in their senior years (male-bodied individuals too).
You may have heard two terms (that are confusingly similar) for decreasing bone mineralization: Osteoporosis and Osteopenia. Here’s a simple definition – these two terms represent a spectrum of severity. Osteoporosis is more severe, and Osteopenia describes the initial stages of bone mineral loss.
As the years go by, we gradually lose bone mass. 54% of postmenopausal individuals in the US have osteopenia, and an additional 30% have osteoporosis (1). There are many reasons behind mineral loss, including:
- Decreasing levels of estrogens (female sex hormones, which have a building/maintaining effect on bones) in females.
- Decreasing levels of androgens (male sex hormones…which have, you guessed it, a building/maintaing effect on bones) in males having a major effect.
- Sedentary lifestyle
- Sub-optimal diet
Okay, that’s a lot of not-so-great news, so what can you do about it? Natural medicine has much to offer to the end of increasing bone density, including many specific supplements, herbal formulas, and dietary recommendations. There’s one major thing that I think we Naturopaths under-prescribe folks like you, and that happens to be my favorite pastime – strength training.
How strength training works
Your muscles have to produce a force, through contracting, to move a stationary object, and this force is equally exerted on your bones. Nature, in her wisdom, devised a simple protective response to this phenomenon: build denser bones to withstand the movement of muscle.
Strength training also has a powerful positive effect on improving your hormonal balance, by increasing sex steroids (estrogens and androgens again), and growth hormone. These all offer substantial benefits to your overall health, promoting longevity, vitality, and graceful aging.
Osteoporosis is a major risk for the elderly
If you have decreased bone density, the risk of “pathological” fractures increases, with 1.5 million occurring in the US every year (2). While breaking a bone is an experience no one wants, the stakes get higher as we age. Hip fractures carry with them the greatest consequences, since your hips tend to be the most essential joints to getting around and living our lives comfortably. More alarming though is that when such a pathological fracture occurs, our individual life expectancy decreases drastically, with some estimates being around an average of four years after such an event, due largely to a much more sedentary lifestyle.
As we age, our balance deteriorates, and we lose substantial strength. Picture another scenario – you are walking and you trip over something. You don’t think through how to catch yourself, you just react. For a younger person with stronger muscles and a quicker nervous system, it’s much easier to catch themselves, but for you, the consequences can be dire.
The Skill of Strength
I happen to be in the rare category of physicians who enjoy strength training on a regular basis, and I have 24 years of experience engaging in that pursuit. Throughout the decades, my overall philosophy regarding the subject has shifted, informed by medical education and world renowned mentors, to the point where I now regard strength as a skill more than an attribute.
When you lift heavy things regularly, whether squatting under a barbell, or deadlifting one off the floor, you are teaching your nervous system the safest movement patterns that allow you the most efficient ways to use your strength. You will develop an intuitive body awareness that will protect you from injury.
I would sound tongue in cheek to say to you that “strength training is the best way to build strength”, however, I notice that when great doctors recommend movement and exercise (the best medicines of all, I’d argue) they often miss the opportunity to recommend strength training specifically as one of the best ways to improve balance and coordination (yoga and pilates are fantastic too).
If you’re afraid of going to a gym or hurting yourself
Hopefully I’ve put to you a strong case why strength training is amazing medicine. Gym culture, however, is sadly an environment where individuals more mature in their years often don’t feel fully comfortable. I want to emphasize the importance of the setting where you will develop strength, and it should be one where you do feel comfortable.
Thankfully, there is an ever increasing diversity of gym ambiences and amenities, so chances are good that with some searching around, you will be able to find the right fit. I encourage you to take advantage of free day passes that gyms often offer, to help you shop around for the place that best fits your individual needs. Also, don’t hesitate to be an advocate for yourself when it comes to stating what you’re looking for in a gym and trainers who focus on people like you, and who have similar health goals. If you’re a resident of the Portland metro area, I have some names of trainers that I know and trust as qualified to work with you, but depending on a few specifics, we should sit down in an office visit and take a few minutes to work out the details.
A little challenge for you
I’m going to ask that you try out a few different gyms (let’s say 3) over the next months to find a spot with an appropriate feel (3). Also this month, let’s sit down so that I can answer your questions, and offer you some more detailed information and recommendations. I’m confident that taking on the new pursuit of strength is one that you will enjoy, and more than that will offer tremendous health benefits, especially stronger bones. After all, we are designed to move 😉
In health,
Dr. Nesbitt
Dr. Grady Nesbitt is a naturopathic physician at Heart Spring Health whose mission is to provide same day pain relief so that you can fully enjoy all that life has to offer. Using a diversity of modalities such as acupuncture, spinal adjustments, and physiotherapy devices, combined with naturopathic staples such as herbal medicine, homeopathy, and nutritional counselling, Dr. Nesbitt provides solutions for sports injuries, all types of chronic and acute pain, and degenerative conditions such as osteoarthritis and osteoporosis. His skills were acquired over nine years of medical training and orthopedic focused preceptorships at both the prestigious National University of Natural Medicine (NUNM) and Bastyr University, as well as decades of athletic pursuit. Click here to learn more about Dr. Nesbitt.
Footnotes
- Percentage of Adults Aged 65 and Over With Osteoporosis or Low Bone Mass at the Femur Neck or Lumbar Spine: United States, 2005–2010 by Anne C. Looker, Ph.D.; and Steven M. Frenk, Ph.D., Division of Health and Nutrition Examination Surveys https://www.cdc.gov/nchs/data/hestat/osteoporsis/osteoporosis2005_2010.htm
- FRAX-based Estimates of 10-year Probability of Hip and Major Osteoporotic Fracture Among Adults Aged 40 and Over: United States, 2013 and 2014 by Anne C. Looker, Ph.D., and Neda Sarafrazi Isfahani, Ph.D., National Center for Health Statistics; and Bo Fan, M.D., and John A. Shepherd, Ph.D., University of California, San Francisco https://www.cdc.gov/nchs/data/nhsr/nhsr103.pdf
- This article was written during the time of the coronavirus pandemic. All franchise gyms are now adherent to health protocols set forth by state and federal governments in order to keep you safe. Use your best judgment for your own health and safety.