How to support women’s bone health at any age
Felice Gersh, M.D.
March, 2023
People take supplements to improve or optimize their health. So what happens when you look at the label, and the ingredient list is filled with unrecognizable additives?
A woman’s bone health at any point in her life is the result of the totality of the life choices she’s made and health impacts she cannot control. Factors like childhood family dynamics, physical activity in infancy and early childhood, diet and exposures to pollution can all impact a woman’s bone health. Although we can’t change the past, understanding its effects can help us better maintain a healthy skeletal system.
Bone Health: Why It Matters
Why does bone status matter? Bone health is intricately related to quality-of-life metrics, cardiometabolic status and even brain function. Bone is a complex organ. It’s involved in blood mineral balance, glucose regulation, mood, cognition, strength and mobility. Bone houses bone marrow, where vital blood products are manufactured.1 Bones produce a hormone called osteocalcin, that maintains proper glucose regulation and cognitive function. Healthy bones are critical for optimal levels of calcium and phosphorous in the blood and to keep our joints optimally functioning.2 It’s a dynamic tissue that is constantly in a state of remodeling – adding new and removing old bone to maintain a strong and healthy skeleton.
Women, Aging and Bone Health
Upon the onset of menopause, women suffer the loss of critical mineralization and become weaker and more prone to fractures. Shockingly, 80 percent of fractures occur in women and 40 percent of women will sustain a fragility-related fracture.3,4 Bone loss can occur quite dramatically and rapidly, sometimes prior to the arrival of the last menstrual cycle and the onset of menopause. Menopause is a process that includes the declining production of estrogen and progesterone, essential hormones for optimal bone health. This often begins in a woman’s late 30’s, which is why recognizing bone health risk factors is so important.
Living With Bone Health in Mind
Optimizing nutrition, stress management, sleep, and fitness during early childhood through age 30 supports the development of a strong musculoskeletal system. A diet of high-quality protein, legumes, whole grains, nuts, seeds and a wide array of fruits and vegetables (especially calcium-rich, dark green, leafy veggies) will provide the numerous minerals, vitamins and polyphenols required for bone health. Incorporating other healthy lifestyle habits, like 7-8 hours of regular sleep, healthy stress management techniques and regular resistance exercise, can all contribute to maintaining your bone health long-term.
Supplementing with targeted nutraceuticals can assist with filling any nutritional gaps. Taking a high-quality multivitamin and multimineral, 1-2 grams of Omega 3, 500-1000 mg of calcium daily is recommended. If necessary, you may need to consult with your healthcare provider about supplementing your vitamin D and magnesium to keep them within optimal levels.5 Following these basic guidelines will help to support your bone health throughout your life.
Ask the Expert
Are there any ways to prolong ovarian function?
Dr Gersh: All women, on all continents, will go through menopause, but there is some variation based on genetics and an array of other factors. Maintaining a healthy lifestyle, eating a wide variety of plants in a plant-based diet, lowering exposures to unhealthy chemicals and pollutants, staying fit, controlling stress, and adding certain supplements may help support ovarian function for a while.
What effects can birth control pills have on bone growth?
Dr Gersh: There is some data that taking birth control pills, especially those with the lowest amount of estrogen, may prevent optimal bone development, when taken during the first decade after the first menstrual period. For bone development, having one’s own hormones, along with great lifestyle choices, is best.
What are some health issues that can exacerbate weak bones during the reproductive years?
Dr Gersh: Gastrointestinal problems that affect digestion and nutrient absorption can impact bone health. For digestive problems or malabsorption issues, discuss all concerns and symptoms with your doctor. Certain antidepressants, acid blockers and anti-coagulant medications can affect your bones. Patients should discuss their medications with their doctor. Keeping inflammation down throughout the body, keeping the immune system properly functioning, and attaining a healthy body weight and nutritional status are essential for optimization and maintenance of bones.
How can stress negatively impact bones?
Dr Gersh: stress can have multiple negative effects on bones. Stress affects digestion and can result in poor absorption of macro and micronutrients. Stress can negatively affect sleep, which is the time the body grows and repairs. Stress increases the adrenal gland’s production of cortisol, catabolic hormone that breaks tissue down, preventing bone building and increasing bone loss.
Felice Gersh, M.D. is a multi-award winning physician with dual board certifications in OB-GYN and Integrative Medicine, with degrees from Princeton University, University of Southern California School of Medicine and University of Arizona School of Medicine.
She is the founder and director of the Integrative Medical Group of Irvine, a practice that provides comprehensive health care for women by combining the best evidence-based therapies from conventional, naturopathic and holistic medicine. For many years, she taught obstetrics and gynecology at Keck USC School of Medicine as an Assistant Clinical Professor. She now serves as an Affiliate Faculty Member at the Fellowship in Integrative Medicine through the University of Arizona School of Medicine.
Dr. Gersh is a prolific writer and lecturer who speaks globally on women’s health and regularly publishes in peer-reviewed medical journals. She has been featured in multiple medical documentaries, including the Real Skinny on Fat, Fasting, and The Business of Birth Control. She is the bestselling author of the PCOS SOS series and Menopause: 50 Things You Need to Know.
- Zhou et al. Endocrine role of bone in the regulation of energy metabolism. Bone Research. 2021;1:25.
- Florencio-Silva et al. Biology of Bone Tissue: Structure, Function, and Factors That Influence Bone Cells. Biomed Res Int. 2015:421746.
- Sozen et al. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46-56.
- National Osteoporosis Foundation data
- Aspray et al. National Osteoporosis Society Vitamin D Guideline Summary. Age and Ageing. 2014;43(5):592-595.
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