- Question from Josepha: I have a family history of osteoporosis after menopause, and fully expected to have to deal with it eventually. Does being thrown into menopause with my chemo put me at a greater risk, or an earlier one than I'd have anyway?
- Answers - Charles Shapiro Risk factors for osteoporosis include, first of all, family history. If your mother had osteoporosis you're at higher risk for having osteoporosis. Another thing is the timing of menopause. Going through early menopause—whether it's related to chemotherapy or some other problem where women lose their ovaries and become postmenopausal—is a risk factor for osteoporosis. Smoking and drinking alcohol are also well-described risk factors for osteoporosis. Exercise and weight-bearing exercise help to maintain bone strength. Lack of exercise means more risk of bone loss, and having a sedentary lifestyle will only worsen the problem.
- Marisa Weiss, M.D. If your mother had osteoporosis and was also a big smoker, for example, then your risk may not be affected by the family history alone. You and your doctor need to consider all these factors together to see if you are at increased risk or not. There have been significant advances in the detection of bone loss, which can help you understand how your own bones are doing.
- Charles Shapiro Another risk factor is the lack of calcium and Vitamin D. One thing we failed to mention is all post menopausal women should have supplemental calcium and Vitamin D because you can't take in enough calcium through dietary sources. The recommendation is 1,000 - 1,500 mg of calcium in combination with 400 IU of vitamin D.
- Marisa Weiss, M.D. That's a good point. Plus everyone needs at least a little bit of sunshine in order to process the Vitamin D properly. Only rarely is this an issue. Women who cover their bodies completely with cloaks or other long clothing on a regular basis need to be careful to get a little bit of light intermittently in order to metabolize the vitamin D and calcium properly.
On Wednesday, August 21, 2002, our Ask-the-Expert Online Conference was called Keeping Your Bones Strong. Charles L. Shapiro, M.D. and Marisa Weiss, M.D. answered your questions about how to measure the strength of your bones, how to find out your risk for osteoporosis, and what you can do to lower that risk.
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