Today, I'm going to be talking about six ways to protect your bones during the menopause.
So, how can you protect your bones?
This is a really important question for a number of reasons. A lot of women don’t think about their bones in menopause as there are so many other things going on. This means that bone health tends to get completely neglected which can lead to problems once you’re post-menopausal, making you more vulnerable to fractures.
And, the number of women who have hip fractures on a yearly basis is really quite staggering! Once you fracture your hip, then that can compound all sorts of other areas of your health as well. So, it's really important to look after your bones as well as you can.
How does menopause affect your bones?
So, how does the menopause affect your bones? The first thing to really consider is falling oestrogen.
Oestrogen has a protecting effect on your bones. So, obviously, as your oestrogen levels start to fall, your bones are less supported as you go through the menopause. You are then at more of a risk of losing bone density and may become more vulnerable to a condition called osteoporosis. In cases of osteoporosis, your bones can get so weak that even a very small stumble can cause a break.
Your nutritional needs go sky-high in the menopause. Your bones are just one area that needs a lot of nutrients, so you need to make sure that you're getting enough of everything so that the body can help to protect the bones itself.
The other problem here is, for a lot of women, they put weight on in the menopause and then they go on crash diets. They go on really low-calorie diets and that's going to cause problems with the bones as well. This is why yo-yo dieting could be considered a contributory factor for things like bone loss and osteoporosis too.
There's also the fact that once you are post-menopausal, your oestrogen levels are going to be low all the time so, again, you're going to be more prone to all these kind of bone problems.
What can you do to protect your bones?
So, how can you look after your bones? What are the six things that you can do to help yourself?
1. Increase your intake of bone-healthy nutrients
So, we need to increase our nutritional intake to help to keep our bones strong and healthy, and stable.
The main things we're looking at here are calcium, magnesium, vitamin D, and vitamin K. Now, so many women to say to me, "Oh, can I just take a supplement?". Now, the thing to remember with supplements is that they are just that – they supplement your diet.
It's far better for your bones and for your body if you can get as much of the nutrients that you need from your food rather than from popping a pill, and it's cheaper, too! Let’s take a look at the best foods that contain calcium.
There are your nuts and seeds, and your beans lentils. A lot of green vegetables, believe it or not, contain plenty of calcium. Dried fruit and dairy also offer a decent intake here. The problem with dairy, though, is that while it’s high in calcium, it’s usually very low in magnesium. Ideally, you need plenty of each to support healthy bones – having high levels of calcium but low levels of magnesium will not help your bones at all.
So, it's really important that if you have dairy, that you have a lot of magnesium-rich foods too. Try to make sure that, if you’re having dairy, it’s organic as this is much better for you compared to non-organic products. You can also look at almonds and tofu or, if you’re not vegetarian, sardines and salmon. The little bones in these fish can be really helpful for your own calcium uptake as well.
When it comes to increasing you magnesium intake, again, your nuts and seeds, your healthy grains and your pulses can go a long way. Quinoa, for example, is a super-duper one of magnesium! Then, you’ve got stuff like your beans and avocados.
I love avocados. It’s great that, these days, you can actually get little mini ones. I very often have them as snacks as they are an excellent way to get extra magnesium into your system. Again, with magnesium, you can also look at your wholegrains as well as your dark leafy vegetables.
There aren’t a lot of foods that contain vitamin D, which is why it's so important that everybody gets a little bit of sunlight on a regular basis to help your body to produce vitamin D in the skin. The foods that will contain a little bit tend to be things like mushrooms, which may come as a surprise.
If you’re not vegetarian, you can look at fatty fish as well –fresh tuna, not tinned, and things like salmon, sardines as well as your dairy, eggs and beef liver.
With vitamin K, it is things like your greens: your Brussels sprouts, cabbage, broccoli, cauliflower, fish meat, and eggs.
So, as I said before, a lot of the foods that you need to have all these are actually foods that contain a lot of them together. Putting these into your diet will go a long way to helping to support your bone health.
2. Support your digestion
So, number two, you need to support your digestion. It’s no good taking foods that are high in things like calcium and magnesium if your digestion is poor. Your digestive system has to work well in order to extract these vitamins and minerals from the food that you're eating.
So if you have any digestive problems, especially stomach problems, then you really need to address that as well. Unfortunately, many women actually end up with digestive problems because of falling oestrogen. They will then go to the doctor and be advised that it’s not linked to the menopause and then be prescribed drugs called PPIs.
One of the issues with these drugs is that they suppress stomach acid and that can, especially over time, interfere with your absorption of calcium and magnesium. If you've been on any of these stomach medications for a while, then it is a good idea just to discuss what's happening with your doctor just to make sure that it's not something you need to be on all the time.
3. Balance your hormones
You need to balance the hormones, so if it's appropriate, you could look at our Menopause Support.
There's also herbs such as black cohosh as well that could be very beneficial. If you're helping to balance oestrogen, then that's going to help to protect your bones too.
4. Exercise to strengthen and protect bones
We're looking at exercise. Weight-bearing exercise is vital for the whole process of building up the bones and keeping calcium in the bones to keep them strong and healthy. So, we're looking at things like walking. Dancing is an absolutely fabulous exercise. It's probably one of the most fun ones and that's a great one for your bones. You're looking at games such as tennis which can be very, very good for this as well.
You can look at hiking. Even just a 15-minute brisk walk a day is going to be helpful for your bones.
You might also find it useful to look at balance exercises. Our balance tends to deteriorate as we get over which can cause falls and bumps resulting in hip fractures. So, practicing a little bit of balancing on one foot and the other could help. I do it at the photocopier while I’m waiting for something.
5. Manage your stress
You need to manage your stress. This is really important. We're all stressed going through the menopause. It's one of the true facts of the menopause is that it's going to cause stress. It's going to impact on your nervous function.
The problem with stress is, if you're getting it every single day, this produces acidic chemicals that can interfere with bone health, and you produce something called cortisol.
And it's known that cortisol can actually block the uptake of calcium, so it's really important to manage stress to keep your bones healthy.
6. Things to avoid or limit
Look at foods to avoid. There are foods that, again, will be detrimental to your bone health.
Caffeine, for example, actually interferes with calcium loss from your bones while alcohol blocks the absorption of calcium. Smoking is another issue to consider – a lot of women who smoke will have an earlier menopause. You will, therefore, will experience lower oestrogen levels for longer and that’s going to cause problems with your bones too. High salt foods are another contender as well!
So, just to recap, you need to be looking at your diet, supporting your digestion and balance your hormones, in addition to exercising and managing stress. I hope you certainly try a few of the tips I’ve mentioned out.
What about HRT?
The other thing to be aware of is HRT and bone health. HRT, because it's giving you oestrogen will have a protective effect on your bones, which is great.
The problem lies in that some studies show that, once you come off HRT, after a number of years, the benefits that you got from the HRT will decrease. A lot of women think that because HRT is protecting their bones, they don't need to put a lot of effort into keeping their bones healthy whilst they're on HRT.
So, for those of you who are on HRT, it's just as important for you to look after your bones now, as it is for all those of you who are not on HRT, and that can make quite a lot of difference the other end of the menopause when you're coming off the HRT.
What else to be aware of?
Medication can interfere with your bone health as well, so, if you're on any long-term medication, then just double-check the patient information leaflet to see if bone loss is a specific side effect and, if it is, obviously, just discuss this with your doctor.
Once you are through the menopause, these things still apply. That’s why it's important to look after your bones, not just through the menopause, but also post-menopause, because your oestrogen levels are going to be continually low at this point.