The MiDOViA Menopause Podcast

Episode 030: Navigating Bone Health Through Menopause

• April Haberman and Kim Hart • Season 1 • Episode 30

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Uncover the secrets to maintaining robust bone health during menopause with Claire Gill, the CEO of the Bone Health and Osteoporosis Foundation. Hear Claire’s personal journey and professional insights into the dynamic nature of bone tissue and the significant drop in bone density that occurs during menopause. She shares invaluable strategies for preventing and managing bone density loss, ensuring you can navigate midlife with strength and confidence.

Dive deep into the critical role of estrogen in women's health, exploring the historical gaps in research and how they've impacted our understanding today. Claire sets the record straight on menopause hormone therapy (MHT), debunking myths and highlighting its safety and effectiveness for women around age 50. We discuss the necessity for more research and better information dissemination so women can make informed health decisions during this pivotal stage of life.

This episode goes beyond hormone therapy, addressing alternatives for those who can't undergo traditional treatments and emphasizing a multifaceted approach to bone health. From practical steps like balanced diets and weight-bearing exercises to the importance of personalized healthcare, Claire provides a comprehensive guide to maintaining bone health through perimenopause and menopause. Join us as we shift the menopause narrative and empower women to thrive in their personal and professional lives.

About Claire:
Claire Gill founded and launched The National Menopause Foundation in 2019 to bring about a positive change in how women perceive and experience health at midlife. In May 2020, she assumed the role of CEO of the Bone Health and Osteoporosis Foundation. She has over 20 years experience in Public Relations and Marketing for national nonprofit organizations and PR firms for Fortune 500 companies.

Websites:
www.nationalmenopausefoundation.org
https://www.bonehealthandosteoporosis.org

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Website: https://www.midovia.com/
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LinkedIn: http://www.linkedin.com/midovia
Email Us: info@midovia.com

MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness & supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.

The information, including but not limited to, text, graphics, images & other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. 

Speaker 1:

Welcome to the Medovia Menopause Podcast, your trusted source for evidence-based, science-backed information related to menopause. Medovia is dedicated to changing the narrative about menopause by educating, raising awareness and supporting women in this stage of life, both at home and in the workplace. Visit medoviacom to learn more home and in the workplace. Visit Medoviacom to learn more. I'm one of your hosts, april Haberman, and I'm joined by Kim Hart. We're co-founders of Medovia, certified health coaches, registered yoga teachers and midlife mamas specializing in menopause. You're listening to another episode of our podcast, where we offer expert guidance for the most transformative stage of life, bringing you real conversations, education and resources to help you overcome challenges and reach your full potential through midlife. Join us and our special guests each episode as we bring vibrant, fun and truthful conversation and let us help you have a deeper understanding of menopause. Hi podcast friends.

Speaker 1:

Today we're talking bone health and menopause. We have a special guest with us, claire Gill. Claire founded and launched the National Menopause Foundation in September 2019 to bring a positive change in how women perceive and experience health at midlife. In May 2020, she assumed the role of CEO of the Bone Health and Osteoporosis Foundation. She joined in 2013 and, prior to that, had a 20-year-plus career in public relations and marketing for national nonprofit organizations and public relation firms with Fortune 500 clients. She's so well-versed in bone health and menopause and we know that you're going to enjoy this episode.

Speaker 1:

Let's dive right in. Hi Claire, welcome to the show. We're really excited to have you here today. Thanks so much for inviting me. I'm excited about this topic. Yeah, yeah, we are too. We get so many questions about bone health and menopause and I know you and I have been exchanging and corresponding for quite some time now and I'm so glad that our schedules were able to sync up and have you on the show today. So you are very busy. I've given the intro at the front end of this podcast, so everyone knows your bio. But, that being said, tell us a little bit about yourself before we dive into the nitty gritty here on bone health and menopause.

Speaker 2:

Sure, well, my background was really in public relations and marketing in my professional career and I did it for a bunch of nonprofits and PR agencies, but I was really drawn back to nonprofit work because that's where I started, and this topic that we're talking about today was also very personal for me About the year before I joined the Bone Health and Osteoporosis Foundation. My mom was 83 and she fell and broke her hip, and my family and I and my siblings we were just so shocked when we found the statistics from the Bone Health and Osteoporosis Foundation about what happens to people after a fracture and, as you have talked about and I know that we'll be talking a lot about today, there was no information. Her primary care doctor didn't even send her for a bone density test after that, and so that's what we see more and more, and so it was really personal for me and then to be able to work on this on a daily basis and make it my career is really a true privilege and honor.

Speaker 1:

Yeah. I realize that you have the personal story and sorry to hear that it took that break for you to find this new career, but so glad that you leaned into that passion. As so many people do, they turn something you know that's not so great into something beautiful. Can you explain what bone health is and why it's crucial for our overall health and well-being?

Speaker 2:

Yeah, I think what many people don't understand and I certainly didn't before I got into this is that bone is living tissue and it breaks down and remodels itself throughout our lives, and it's one of those rare instances where when we talk about bone health and we talk about bone issues, it really is from birth to grave. Right, we build all the bone density we're going to have for our entire lives by our mid-20s. So it's really important in our younger years to be doing things that are healthy, that make sure that we end up with the strongest we call it peak bone mass the strongest, densest bone you'll ever have, and then the rest of our lives that bone density is remodeling, breaking down, building up, breaking down, building up and then when we reach midlife, it starts to change a little bit. The process slows a little bit, which is why many people think that, oh, falling and breaking a bone is just what happens to older people. It shouldn't. If the bone is healthy, we should be able to fall and not break a bone at any age, and so really focusing on bone health throughout the lifespan is so important, but then also keying into those moments that are particularly important for people and for women.

Speaker 2:

It happens to be menopause, that's when we see the most dramatic drop in our bone density, and so that's when we see the most dramatic drop in our bone density, and so that's why osteoporosis is seen as more of a woman's disease than a man's disease, but it impacts both severely. It's just that women have a more dramatic loss of bone density at midlife, whereas men do not have that dramatic loss, and so that's really important to think about when we're talking about bone health. And what is bone disease? Osteoporosis means porous bones. It just means that the architecture that we have of our bone it's kind of like a honeycomb, and then as we again, as we age and we rebuild, that honeycomb either stays tight or it starts to separate and you see greater holes, and that's what we see for people with osteoporosis. The architecture of that bone inside is starting to break down a little bit, but the good news is there are many things we can do to both prevent and to manage our bone health throughout the lifespan.

Speaker 1:

So, good. I can't wait to get to that yeah.

Speaker 3:

But what is bone density? I mean, is it the honeycomb idea that you're talking about? Because I went and got a bone density test. I'm not even sure what they're looking for. I knew I was supposed to do it. Was it good or was it bad, like what? What is bone density when we're thinking about that, as we go to mid-age and we're supposed to increase our bone?

Speaker 2:

density. Bone density is the density of the bone, how strong and tight it is with inside the bone, and so when we measure bone density as a way to determine whether or not someone is osteoporotic, it is looking at. What your test was looking at is comparing, in a couple of spots in your body, your bone density compared to that of a healthy 30 year old, right? So if we say that we build bone density to our late 20s, okay, so now we're at, like you know, 30, that's what they're comparing your bone density to, and what we know is that if it's zero or above, then everything's great. You're kind of matching along with bone density. If it's anything up until like a negative from negative 0.1 to negative 2.4, then you're considered to start having low bone density, and the closer you are to negative 2.5, which is the cutoff, that says you're actually osteoporotic. That is what you need to be aware of, and so it's basically just saying this is giving you a kind of a view on where you are at that stage of life. The other important thing to know about when you look at your bone density test is, although they measure you at a couple of different points your arm, your hip, et cetera, and gives you scores, what they're called T-scores. That's what that negative, minus, or you know, one plus one plus two negative three. So if say, for example, that some people say to me they're like, oh well, I have osteoporosis in my hip because the T-score at the hip was negative 2.6 or 7. But the others were still in the osteopenia range, maybe negative 2.1 or whatever.

Speaker 2:

It's all osteoporosis. You don't have osteoporosis in your hip. It's just showing the density within that particular area. But it's not like you only have osteoporosis in your hip. We don't do it that way. It's not like I just have arthritis in my knee. Do you have osteoporosis on any of those spores? It's osteoporosis, so it should really be paid attention to. But yeah, that's a little tricky when they talk about T-scores and stuff and again, it's hard for people to understand. But that's what they're really, comparing it to your bone density, to that of what you would have had at 30.

Speaker 1:

And what is? I keep hearing conversation about bone density versus bone resilience. Is there a difference and what is the difference? Should I be concerned with that?

Speaker 2:

Yeah, yeah, there's. You know people use different terminology around it the. I think they're talking more about the architecture of the quality of the bone when they talk about resilience. So so, for example, my mom broke her hip, which is absolutely a diagnosis of osteoporosis, but her T-scores still showed her as low bone density as osteopenia. So she didn't, you know. So the quality of her bone wasn't nearly as good as the quality of someone else's bone who was osteoporotic or, you know, had osteopenia and hadn't broken Right. So that's another thing that we're learning.

Speaker 2:

As you know, the decades have gone on. You know, our organization is 40 years old this year and when we, you know, started out, it was really just finding the T-scores as being oh okay, this is what creates someone, how we know someone who has osteoporosis. But then again, science has proved there were other factors where we could then say this is a clear reason for someone to pay attention and get treated or to have follow-up and get treated or to have follow-up, one of those being, if you fall and fracture over the age of 50 from a standing height right now, like they're saying so, like not a car accident, although that's being questioned in new science but if you're just walking, you trip over the curb, you fall on black ice, whatever it is. If you fall and break a bone, that is automatically a diagnosis of osteoporosis. The only bone breaks that are not considered osteoporotic are your fingers, your toes and your head.

Speaker 3:

Interesting I was pretty proud of myself the other day when I fell and didn't break anything. I know.

Speaker 1:

I'm glad to hear that.

Speaker 2:

When you're able to bounce a little, but that's that's a really good point.

Speaker 3:

So what's happening in in menopause and post-menopause is is it just simply the hormones are going down, so there's no lubrication for those bones and you're not building up anything like what's happening and and you know we'll get to like what should I do about it? But what's really happening that I should be aware of and be careful about?

Speaker 2:

What's really happening and that you should be aware of and there's only some things you can do about it is the loss of estrogen. Estrogen plays such an incredible and impactful role on women's health and, unfortunately, we don't know enough about it yet. There's still so much work to be done on women's health research, and I pointed this out to people recently a few times because it shocked me, but last year, in 2023, was the anniversary the 30th anniversary of when women were mandated to be included in clinical trials.

Speaker 1:

Amazing and crazy In our lifetime.

Speaker 2:

It's just shocking to me. So you know again. That's why we don't know all of these things. It's amazing how much we do know now, 30 years later, when they've started to include women and not just test on men and then apply it to women the early leading studies on cardiovascular disease and women at menopause there were 1700 men in this study, wow, wow. That's where it begins.

Speaker 2:

So estrogen we do know it's the loss of estrogen and this powerful hormone that we have, and progesterone, and so we lose up to 20% of our bone density in our first five to seven years post-menopausal right. While the body has a product drop, then we kind of again our hormones kind of balance, again resettle after that, and so there isn't such a great drop after those first few years. It is, but the remodeling slows a little, you know. So that's kind of what it is. So I say that as about what you need to be important, what you need to be aware of, but you know only certain things you can do about it. We do know that hormone replacement therapy, now called menopause, is hormone therapy that has been shown to help prolong bone strength for the time that a woman is on the hormonal treatment, obviously because we're getting more estrogen and that's a key component of it.

Speaker 2:

And then that also leads to the questions people had about, oh well, the safety and efficacy of hormone replacement therapy and why people haven't had it.

Speaker 2:

And so, again, science has been updated and we now know what was looked at during the Women's Health Initiative back in, you know, 20 years ago, was looking at the increased risk for women who were on hormone replacement therapy at 65, and their increase for breast cancer and heart disease.

Speaker 2:

And when they actually went back and looked at that cohort of women who were at 50, taking hormone replacement therapy, who were at 50 taking hormone replacement therapy, there was no increased risk. So that's good for all of us to know that. What we now know is it is really safe and effective. It's just a shame that a whole generation, two generations of women, suffered through all the symptoms of menopause and lost more bone density because they were provided with this really safe and effective treatment. So we have a lot of work to do collectively to get updated on women's health, do more research around the things that we don't know and then provide what you're doing now right, giving women this information about what they can and should be aware of, and to be able to talk to their healthcare provider about whether or not it's right for them.

Speaker 3:

Yeah, recent data from the menopause society says less than 2% of women are taking MHT, which I can't even believe because everyone, including myself, that I've talked to is like game changer. It's a game changer.

Speaker 2:

It is a game changer and it's really sad because I can't tell you how many people I speak with from the National Menopause Foundation who'd be like I'm not touching it. I've heard you know those things, I know this. My doctor said to me and same thing. We are in the same issue where a lot of clinicians aren't aware of the new science and are afraid to prescribe it and, as you said, it can be a game changer. Now, not all women are, you know, candidates for hormone therapy, but we do need to, but that's a much smaller number than the women who do qualify for it and can't get relief from it. So let's start with that and be very grateful that companies have been working hard to come up with hormonal process products, and so we have one FDA approved in that category and there's another coming to market, and so there'll be even more choices for women who aren't able to take menopause hormone therapy for whatever reason, but will potentially be able to take these non-hormonal versions will potentially be able to take these non-hormonal versions and so good.

Speaker 1:

Yeah, so good, and I don't want to necessarily get off on a side tangent on hormone therapy, but there is some talk about testosterone as well, and I know there needs to be more research done in that area, just like everything else in women's health. But I'm wondering what your take is on testosterone and bone health as well.

Speaker 2:

Well, exactly like you said, there's been some talk about it and some studies coming about it, but there needs to be so much more done before we're able to actually make a recommendation. I think individual providers are doing it based on what is right for the person patient in front of them, and that's important, and we need more of that too, and I'm pleased to see that some of medicine is heading in that direction where we're talking about personalized medicine, because what's right for you and what's right for me and what's right for Kim are not necessarily the same, and that's true for men and women, but particularly women, when we don't have the answers yet to what applies to all and what applies to some. So, yeah, so there are again lots going on and, as you said, that's also a thing that many women don't even know, that you know we produce testosterone too, and when that goes off balance as well. It's all related to how we age and whether or not we age healthfully and what we become at greater risk for as we age because of these hormone changes.

Speaker 3:

Yeah, yeah. So, taking hormones aside, what steps can people do to maintain healthy bones while they're going through the, you know, perimenopause, through menopause, what can, what can women do to keep their bones strong?

Speaker 2:

It's the same thing we do to build strong bones. It is eating a healthy, well-balanced diet that again has fruits and vegetables, lean protein, healthy fats. All of that those things that we need to do for our heart health, for our brain health, for diabetes. All of those things are the same for bone. The only difference or increase would be paying close attention to your calcium levels and vitamin D. Okay, and again, calcium bone is made up of calcium and other proteins, and so calcium is one of the leading ones. And then vitamin D helps the body absorb calcium, and so you need both to be at optimum levels to be able to maintain your bone health and to make up for some of the bone loss that we have naturally as we age. So our need for calcium increases a little bit from your 50 until after 50, only about 200 milligrams. It's also really important to talk with your healthcare provider about your specific levels. How you absorb calcium is going to be different than how I absorb calcium. Your vitamin D levels are going to be different than mine, and I joke all the time for people who can see me I'm like clearly, with this Irish skin, I am vitamin deficient. My level is far greater than many other people, even living in my neighborhood. So that's something to be checked and make sure you're doing that, because you want all your good work right. If you're getting calcium and exercise and you're eating well and you're doing all these things and then you're low in vitamin D, which we just tend to be many in the United States, then that's something to check to make sure that you're doing that. The types of exercise are also important. So, while we're paying attention to our cardiovascular health, and swimming and cycling and things like that are fabulous for your cardiovascular health, they're not good for your bone health.

Speaker 2:

Bone health you need to be on your feet. We call it weight bearing, so you need to be on your feet. We call it weight bearing, so there needs to be a little impact. It doesn't have to be jumping rope or running, although those are good and definitely good for younger people. Building to people, mass walking, anything that has that impact, that you're pressing down, that you're on your feet doing, are good.

Speaker 2:

Dancing, hiking, you know, anything that has you on your feet and moving are really important, and the other part of that is muscle strengthening. That helps. I mean, if you think about it, obviously our bones, but our bones are protected by the muscle. So that's what's going to help keep the muscles, the bones, strong, keep us upright, keep us flexible and moving so that we don't fall. So the muscle strengthening is really about balance and strength. And, again, it doesn't matter how old you are or what you do. Weights lifting any kind of weight is really really good for your health overall is really really good for your health overall, but particularly for your bone health. So definitely want people to talk with their healthcare provider before starting any kind of exercise routine. And it might vary certainly by where your risk of fracture is right. Those with low fracture risk can obviously lift more and do more than those with higher risk.

Speaker 2:

But no matter what your risk, there's always something you can do to kind of keep working at maintaining or building your bone strength.

Speaker 1:

Yeah, kim and I both have our weighted vests now. I know that those are becoming more and more popular and it does make a difference, I think you know, just having that little bit of extra weight while we're walking so that you're building the strength and muscle.

Speaker 2:

It can be really safe and effective for many people. You know there's lots. Again, it's as long as you're talking with your healthcare provider, making sure that you're not risk, because obviously if you were severely osteoporotic and you're adding extra weight, not a good idea. But if you're healthy and you're doing it to make sure that you're maintaining your bone health, then it can be a great option and that's it. It's really finding what works for you and doing that.

Speaker 2:

I think the other thing, when we talk about these wonderful things we can do to build our bone strength and maintain our bone strength, there's a caveat in that there are some things and risk fractures that we can't control, and I think that's what's so upsetting for many people, particularly people who call and reach out to us at the bone health and osteoporosis foundation. I have a lot of women and men who call and say I've done everything right, I'm in shape, I run, I do this, I eat a healthy diet, I don't smoke, I haven't drank. Why do I have this disease? And it's like well, did anyone in your family have?

Speaker 2:

it your parents have it. Whatever, it is hereditary, so your risk goes up If you've had a family member who's diagnosed with it or unfortunately, like we said, so many people go undiagnosed that you know I need to think. Did grandma break her hip? Yeah, yeah, so that might be it. She might never have gotten diagnosed, like my mother didn't, right. But you know, oh, wow, that puts me at greater risk.

Speaker 2:

Having a smaller frame, right, also, there's only again, so my bone density is a big bones person, right. I was like, oh, finally, these linebacker shoulders are going to be good, I have more, there's more room right To build density. Then there would be someone on your frame, right, those of us. Again, I was quickly, it was quickly pointed out to me that just because I have a larger bone mass right bone, doesn't mean the quality inside right and and being overweight and not doing exercises and not doing these things can actually impact that too. But for those people with smaller frames, again, you might've built a pink bone mass and done everything right, lost some, you know, at a density at menopause and it's just put you into that risk category, you know. So you know, I get people feeling really guilty Like they've done something wrong when they like what did I do?

Speaker 1:

What could I have done Right? Why didn't I what?

Speaker 2:

could I have done. It really is that moment of.

Speaker 1:

Yes.

Speaker 2:

You're doing. What's more important is that you're now aware and that you move forward to take steps to prevent the fractures. That's what we really need to do and I think encouraging people with that is a very important part of what we try to do, Because I tell people yes, I understand when you get told that you have a chronic disease and you need to do something and you might fracture and it could cut your life short all of those things. That's a horrible thing to hear. Then, when you breathe and digest and say, okay, it's manageable, it's treatable. The drugs for treating osteoporosis and preventing fractures are more effective than statins are at preventing heart attacks.

Speaker 1:

That's great.

Speaker 2:

Yeah, good to know there's some good stuff there. No one wants to take medication, as we all know. None of us want to go on medication. But if you're at high risk for fracture and really ending up either God forbid dead or in assisted living or in a nursing home, the risk of taking that medication are far less than what could happen if you fracture. And so, again, it's a dialogue that people have to have with their healthcare provider about what's your risk, where are you in the grand scheme of things and whether or not treatment is really right for you. And we've had again, like you said, kim, I've had so many people who fractured, fractured, fractured, took forever to get diagnosed with osteoporosis again, finally did got on medication and we're like, oh my God, I can't believe that I've not fractured, you know again. And so those are things too that we need to make sure that people are aware of that there are. There are a lot of good treatments out there If you can find a practitioner who can walk you through those details.

Speaker 3:

That's great to know.

Speaker 1:

You know, we hear, okay, we hear all the time when we talk to people. I, oh, I don't need to know about menopause, I'm already beyond that. And they hit that menopause birthday right or anniversary or whatever we want to call it party and they're on the other side of it and we hear oh, don't need to know, Thank you very much, but don't need to talk about it. What would you say to people that say that Is it too late? Is it too late to prevent fractures and take care of our bone health?

Speaker 2:

I mean, yeah, we always say it is never too early or too late to take care of your bone health. Whatever age you're at, whatever physical ability you're at, it's never, never too late to start or continue. I think what's important when women think about menopause and I've passed menopause so I don't have anything to think about, you don't have to think about your menstrual cycle anymore, and that's a relief to so many women but it is time to take stock of all of the things that we become at increased risk of because of the loss of estrogen. So, for women who you said, menopause what we think of as menopause, which is just the the one year anniversary of your last menstrual cycle, they call it the final period. Um, that just means that's menopause.

Speaker 2:

The journey to menopause, all the symptoms that we have and all the things that we have to deal with, can start as early as late thirties, early forties and no one tells women that either. You know, oh, it's not when you think you're old that menopause happens. It's, you know, for me, the year after you had a baby happens.

Speaker 1:

It's you know for me the year after you had a baby.

Speaker 2:

Yeah, you were early menopause too. I was too, yeah, yeah. So I think that's really important. It's a journey. This is a journey and it's very unique for every woman too.

Speaker 2:

We do averages, right, the average woman, you know. And just menopause at 51 is what the you know, the anniversary of their last period, but it continues. And then our risk for heart disease, breast cancer, osteoporosis, dementia, all of these things diabetes increases after menopause. So that's when they really should start paying attention to even more aggressive. Look at how are they doing health-wise, are they checking in on all of these things? What's their family history for all of these different conditions too, which can put them at an increased risk. So, like anything, life's a journey, and just stop caring about something you know. Once it happens, it's like, oh, I had a baby, I don't need to talk about having babies Exactly Four years with that thing you know. Once it happens, it's like, oh, I had a baby, I don't need to talk about having babies Exactly Four years with that thing you know you need to pay attention to it.

Speaker 3:

Well, that's the thing, right, that process in our lives might be changing, but taking care of our health never changes. That's so good. So what should people be doing to understand where they are in their bone test? Is a bone density test worth it? What should they be looking for to know where they are in their bone test? Is a bone density test worth it? What should they be looking for to know where they are in this journey? And then, what should they think about? We talked about all the lifestyle and diet changes, but is there anything else that they should be thinking about to make sure that they're going into the last part of their life as strong as they possibly can?

Speaker 2:

So right now, the clinical guidelines for bone density tests say that women should be tested at 65 and that men should be tested at 70. Obviously, that's not going to do much for prevention, but that's where the guidelines are, and so we're definitely talking more about the need for earlier testing for bone density. If you have risk factors and beyond the ones we've talked about, you know, on this podcast there are. There's a list on our website because there's a lot, because there's a lot Eating disorders, intestinal, you know, digestive issues, autoimmune diseases so many other things that impact our bone health, unfortunately, because it disrupts that remodeling process and many times it's the treatment for it. So if you're on an autoimmune disease and you're on steroids, steroids sucks calcium from your bones to things right. So it's that again, looking at that whole person versus just one aspect of it is really important. So we should make sure that, again, if we have any risk factors that we talked about to our health care provider, about getting an early bone density test because you can, about getting an early bone density test because you can. The other thing I tell people and this is only for people who can afford it and unfortunately not everyone can but if it's something that's really bothering you and you have the means. Bone density test is about $125. So as much as that is a make or break for many people in our country. When you think about some of these other testings like MRIs or things that you need to get diagnosed, it's not nearly at that level. It is within that range, and so that is something to consider just paying for it yourself if it's really important for you to have that baseline.

Speaker 2:

The other things that we should be doing are increasing the weight-bearing exercise and the muscle strengthening as we age. Much like one of the symptoms of menopause where women get upset about oh wait, I've eaten the same, I'm training the same, I'm doing everything the same and yet I'm gaining weight, doubtfully in my abdomen. Biologically, what happens after menopause is the fat in our body shifts from our hips to the abdomen, and so I've had women say my jeans don't fit right, my blouse isn't buttoning the same way, I weigh the same. Why is that? It's literally a physical shift where the weight is so starting to look at those things in your routine and how you might, you might have to actually cut back on calories a little bit. You might have to step up a little bit more of your, you know, cardio kind of stuff to kind of weight bearing stuff.

Speaker 2:

Those are all things that can be done. And then really preparing to have that conversation with your doctor here's what I'm concerned about, here's what I want to know with your doctor, here's what I'm concerned about, here's what I want to know and working on a plan that gets you the information you need at baseline to be able to monitor and move forward. That's great Because we can do really.

Speaker 2:

And then again, no smoking, which we all know no smoking, not drinking too much, and I love the too much statistic because the studies actually say more than two to three drinks a day are a risk for osteoporosis and I'm like if we're having more than two to three a day, osteoporosis isn't our biggest problem.

Speaker 1:

Yes, exactly, I'm like two or three a day, but if you're having a glass, of wine a couple times a week.

Speaker 2:

You're fine. Don't worry about that. But again, don't get into retirement and then start having cocktails every day. Cocktails after things. Those are things that we can pay attention to.

Speaker 3:

Right, that's great. Well, I will say that the DEXA scan is about the easiest possible thing I've ever done from a scanning for my body perspective. I just laid there talking to the guy for you know whatever, seven, 10 minutes, and he, I was done and I'm like okay, Okay.

Speaker 1:

That's good to know. I'm up next.

Speaker 3:

Yeah, I can do this.

Speaker 2:

I joke, I've. I've said this so so many times. We should tell women that it's incredibly embarrassing and painful and awkward, and women will line up to do it right. We all have mammograms and colonoscopies, but no one gets a bone density where it's yeah, you don't even take your clothes off yeah, no you don't have to take anything off, which is so weird, and you lay there, almost get a little mini nap.

Speaker 3:

so you know I'm in yeah.

Speaker 1:

Well, and I think you you brought up an important point too, because it's recommended, without other risk factors, that you get the DEXA scan at 65, you know, with not knowing that it is 150 bucks, let's call it, I would have thought thousands out of pocket for a DEXA scan. So that's actually great information to have. Yeah, and like I said, it's, and then there's other.

Speaker 2:

You know, in some communities there's hospitals that will do free clinics and do it.

Speaker 2:

You know those kinds of things. So you know, hopefully, that. But if you have a risk factor, there are ways on Medicare, medicaid and insurance to be able to get you the bone density test. So sometimes it's finding a specialist who knows that right, because general primary care unfortunately doesn't know anything about bone, just like they don't know anything about menopause, and so we have to be our own best advocate in doing and getting what we need. Hopefully that will change, but it has nothing to do with the clinicians not wanting to provide good care. They are overwhelmed and so really we do have to advocate for ourselves.

Speaker 2:

I also heard something recently, a statistic about that women today, current midlife women, women going through menopause, are far more informed than any of their clinicians about menopause. Right, we're doing our own research, we're really taking that into heart, and so that's great and that's good. Yeah, the same with your thing. Advocate for yourself. Advocate, that's great and that's good. Yeah, the same with your thing. Advocate for yourself. Advocate for your parents too, when they're again going through these stages of life, if they fall and they break a bone and no one follows up on that. Don't let them just fix the fracture. Make sure that they are sent to someone who can evaluate them to find out if osteoporosis was the underlying cause, because it is, and that's your male family or your female, it doesn't matter. Grandpa and dad and stuff like that they too. And unfortunately for men, even though it happens, osteoporosis happens later to them. Their fracture outcomes are worse. So you need to pay attention to the whole family.

Speaker 3:

Wow, I appreciate that. That's good.

Speaker 1:

I think about where where can people find a good provider if they have concerns about osteoporosis and bone health?

Speaker 2:

If they're having the discussion with their current primary care and then they're not getting any kind of adequate response, then ask for a referral to osteoporosis specialists. We do have a list of some on our website but, honestly, that whole section needs to be updated tremendously and we just haven't been able to get to it yet. Needs to be updated tremendously and we just haven't been able to get to it yet. So you can always reach out at info at bonehealthandosteoprosisorg and we will try to help individuals find someone close. But I would ask your doctor for a referral, which makes people feel a little, you know, sometimes uncomfortable too. Not helping I need to do this, but just express your concern too. Not helping I need to do this, but just express your concern. Nine times out of 10, they're so busy. They are happy to refer you to someone who knows what to do. So don't be afraid to ask. Yeah, if you're not comfortable with that or you don't get a good response with that, check with your local hospital. Is there someone in your system who is an osteoporosis expert?

Speaker 2:

And another great way to get a name of a doctor who wants to do that, and so that's how you know I've been encouraging people to to find a specialist. Honestly, for most people unless it's complicated with you know lots of fractures and you know all the kinds of stuff you should be able to get your bone density test. You should be able to get treatment that you need right On that. It's when it's very concerning or you're really high risk that you likely need to see a specialist.

Speaker 1:

Okay, okay, that's good advice. That's good advice, and we are going to put links in show notes, and then you also are a part of the menopause foundation, so we can all reach out to that website as well. That we'll put in show notes, because I know you have a lot of resources on your website as well, so thank you for building that out and providing resources. We're just coming off of perimenopause month. Today's the last day for perimenopause right. That was a big yay right Confetti, for bringing awareness to that in September, so thank you for your part in that as well. Yeah, is there anything else that you would like to share with our audience before we dive into our rapid round?

Speaker 2:

I really, again it is. It is that, that notion that it's never too late to start taking care of your bone health at any age, and there's always something we can do to improve it and to pay attention to it, the same way we do all the other areas we focus on for our health. So just keep that in mind for all the people that you love.

Speaker 1:

Yeah.

Speaker 3:

Yeah.

Speaker 1:

It's important, it's really important, and I think we don't often think about our bones until something happens. So I'm so glad that we had this conversation today. Let's have some fun, let's get to know you a little bit better. Claire, we're going to go into our rapid round and we want me to start. Kim, sure, go. Okay, I'm going to pick a question here. What is your favorite way to unwind?

Speaker 2:

Reading. I love to read and I actually like to read books. I spend a lot of time on my phone and on my computer and on social media, but when I want to really relax and read it's with an actual book in hand.

Speaker 1:

So fiction or nonfiction? Yeah, that was my question.

Speaker 2:

Yeah, I like nonfiction. I've read some really really great biographies lately, but I prefer nonfiction. I like it as escape.

Speaker 3:

What is the most unusual thing on your bucket list that you'd want to do?

Speaker 2:

The most, thing, sorry, say again.

Speaker 3:

The unusual, the most unusual thing on your bucket list that you'd love to do.

Speaker 2:

Bucket list. The most unusual thing on my bucket list can never happen. Now, I have to say, because I wanted to be a backup dancer for Tina Turner. Backup dancer for Tina Turner, that was one of those things that was like, oh my God, just let me put it in practice. I've never danced in my life. It was just watching her perform and I just thought the coolest thing ever would be being a backup dancer for Tina Turner.

Speaker 1:

So, other than that, I would like to visit every continent. How close are you?

Speaker 2:

Oh, not even close. Okay, I've been. I've only been to North America, South America, Europe kind of stuff. I still have so many more to go, but I think it would be very. That would be really cool and that's a fun goal.

Speaker 1:

Yeah, yeah, you can make that happen. Yeah, maybe we'll go with you. Let us know when you start that. Yeah, yeah, road trip. Yeah, road trip, okay. Speaking of road trips, do you enjoy city life or country living?

Speaker 2:

I'm definitely a city girl and I love both. I was born in the Bronx in New York city and then moved to a 50 acre farm in Catskill when I was seven, did it all. So I can do both, I love both, but I think in my heart of hearts I'm a city girl.

Speaker 3:

Okay, can't take the city out of you. Well, I love that you can qualify it because you've done both, so that's pretty good, all right. So our last question that we ask for all of our guests what is the best piece of advice you've ever received?

Speaker 2:

There's so many possible answers to that and I even heard a really good one today that I should say but I think lifelong, one of the best pieces of advice was more a comment that my mom would say to us when we were dealing with whatever struggles or anxieties or worries that we had, and it was that don't worry, the sun will come up tomorrow. And that mattered a lot in my life. And after we talked about again those things where you're in your mind, my mom has passed away, and we talked about how do you deal with grief, how do you deal with this and whatever, and she's like you have no choice the sun comes out tomorrow. Yeah, so that's not quite advice, but that's really that stuck with me most in my life yeah, yeah, I, yeah.

Speaker 1:

I love that the sun will come up tomorrow. It always does, right, oh it? Always does yeah, whether we want it to or not.

Speaker 2:

Right no Right True oh but I could use, I could. I could use a few more sons and sleeps and such.

Speaker 1:

We used to count them right how many sleeps until Until I get to two X right, or until you're old.

Speaker 2:

Yeah.

Speaker 1:

Yes, yes, we don't talk about sleeps anymore, like how many sleeps until we're like we're not sleeping anymore?

Speaker 2:

I try to tell my daughter that napping like when you feel like literally napping will become something that she so desperately loves as she ages. And you want to when you're young. And then a good nap, oh my God, so good.

Speaker 1:

Yeah, so good, and it's just like the cherry on top when you get to take a nap.

Speaker 3:

Sarah, what a delight. Thank you so much for taking the time today. You really you're a fountain of knowledge that I know a lot of people have heard about and really just wanted to clear the like noise, to break it down simply, and so thank you for for taking so much for talking about this.

Speaker 2:

It's so important and I really appreciate you focusing on it. And so thank you for for taking so much for talking about this. It's so important and I really appreciate you focusing on it. And again, any way that we can assist at the bone health and osteoporosis foundation, please tell people not to hesitate to reach out to us. That's what we're there for.

Speaker 3:

Perfect, we will, we will.

Speaker 1:

And audience. With that we're going to sign off. So until we meet again, go find joy in the journey. Thanks, claire, thanks Bye. Thank you for listening to the Medovia menopause podcast. If you enjoyed today's show, please give it a thumbs up. Subscribe for future episodes, leave a review and share this episode with a friend. There are more than 50 million women in the US who are navigating the menopause transition. The situation is compounded by the presence of stigma, shame and secrecy surrounding menopause, posing significant challenges and disruptions in women's personal and professional spheres. Medovia is out to change the narrative. Learn more at medoviacom. That's M-I-D-O-V-I-A dot com.

People on this episode

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April Haberman

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Kim Hart

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