I have been in postmenopause for 5 years. I’ve always been faithful about exercise, weight-training, and taking my calcium, and yet I’ve recently been told that I have osteopenia. Why didn’t doing these things prevent bone loss? What more can I do?
Being postmenopausal is the most significant risk factor for having osteopenia and osteoporosis. Don’t forget that if you are postmenopausal, you may lose about 2% to 5% of your bone mass per year for the first 4 to 8 years following menopause.
Because you are between 4 and 8 years postmenopause, you are experiencing the time of greatest bone loss. Even with the explanation of being postmenopausal, it can feel pretty discouraging if it seems like you’re doing all the right things but you find out you have bone loss anyway.
This doesn’t mean that you are doing anything wrong. And you absolutely should not stop exercising and taking your calcium and vitamin D.
Your healthy habits may not have prevented osteopenia for several reasons. First, look back at your pattern of growth and food intake. Were you very thin as a child and adolescent?
Did you drink enough milk and eat plenty of dairy products? Was your diet overall a healthy one with a good balance of protein, carbohydrates, and fats, without a lot of junk food, soda, and coffee?
If you were excessively thin; if you did not get enough calcium, vitamin D, and other nutrients; if you smoked; or if you consumed excessive amounts of caffeine- and phosphorus-containing foods and beverages that replaced those with calcium, it is possible that you did not reach peak bone mass as a young adult. Therefore, your T-score may reflect a failure to reach peak bone mass rather than loss of bone mass as a midlife adult.
Second, what is your family history? If you have a first-degree relative (mother, father, sister, brother, daughter, son) with osteoporosis, you are much more likely to have osteopenia or osteoporosis even if you’ve done everything you can to prevent bone loss.
Third, do you have other risk factors besides family his-tory that may have contributed to the condition of your bones? For example, if you are on steroids for chronic asthma or other medical conditions, significant loss of bone density can happen in as little as 3 weeks. Unfortunately, steroid use can create loss of bone density faster than exercise and calcium can increase it.
And fourth, are there lifestyle changes that you should be making? You already exercise and take calcium, but you should also quit smoking and cut down on alcohol if you are consuming more than one or two drinks per day.
Regardless of how you happened to be diagnosed with osteopenia, you will need to discuss goals and treatment with your clinician. Even though there are other reasons why you may have sustained bone loss, you should also reexamine your exercise regimen. Are you gradually and consistently increasing load on your bones?
And have another look at your calcium supplementation to make sure you are correctly calculating how much calcium you are taking in through diet and supplements. Add more calcium if you are not getting enough . Prescription medications may prevent further bone loss.
You have a chance to make some real changes in your life based on that one bone density test, so take advantage of this opportunity. There’s always more we can do to get and stay healthy.