The New York Times recently reported on research that found high doses of vitamin D don’t increase bone density in healthy adults (aged 55 to 70 years), and it may even decrease it, although further research is needed on that. So vitamin D is important to your health, but you don’t need more than the recommended daily allowance (600 IU), which you should be able to get through a balanced diet and direct sunlight. If you live in an area that doesn’t get a lot of sun for long stretches of the year, you may need to take a supplement to get the recommended amount.
With that in the news, it seems like a good opportunity for me to reiterate what does and doesn’t help with bone strength after menopause. The biggest misconception has to do with calcium. While calcium does strengthen the outer shell of the bone, it doesn’t help the osteoid—the collagen fibers inside the bone that allow it to flex without breaking. Calcium supplements don’t guard against fractures because they don’t help the bone’s resilience. Bisphosphonates like Fosamax improve bone density but won’t reverse osteoporosis once you have it, and not every woman can tolerate them.
What does work? Hormone therapy. Estrogen significantly reduces the risk of hip fracture, perhaps by as much as 50 percent, according to multiple studies. Osteoporosis is a chronic condition, and I think women need to safeguard their bone health as much as they do their breast health.
In one of our recent Fullness of Midlife interviews, Dr. Avrum Bluming, who co-authored Estrogen Matters, said, “In the United States and throughout most of the western world, the number of women who died within a year of a hip fracture is about the same as the number of women who die of breast cancer. That is often ignored, and it shouldn’t be.”
When it comes to bone health, hormone therapy should start as soon as possible once you hit menopause, because the most rapid bone loss occurs in the first five years of menopause. Also, hormone therapy benefits the bones only for as long as it is being taken. Each woman has her own risk factors, symptoms, and preferences. I encourage you to talk to a knowledgeable professional about how you can best protect your own bone health.
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.