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In the process of trying to build a successful career and taking the primary responsibility of household work and childcare, they end up neglecting their well-being.
While there are several health (mental and physical) conditions plaguing modern women, deteriorating bone health is considered to be one of the major ones worldwide.
Experts say that the absence of adequate care can weaken or damage the bones over a period of time. This can lead to various bone diseases, including the most-common condition — osteoporosis. Bone disease occurs when the body loses too much bone mass, makes too little of it, or both.
A World Health Organization report says that osteoporosis is the second-most global healthcare problem, after cardiovascular disease. In fact, some studies suggest that Indians are more vulnerable to the bone condition due to their lifestyle and genetic factors.
Explaining the bone disease, Dr Vineesh Mathur, Director-Division of Spine, Institute of Musculoskeletal Disorders and Orthopaedics at Medanta Hospital, Gurgaon, says the condition can make the bones weak and brittle, which can further make them susceptible to fractures even at the slightest impact. "The condition can be debilitating and can handicap people, making them dependent on others for their mobility. This can cause significant emotional distress," he adds.
According to the Health Ministry’s National Health Portal, women are at greater risk of osteoporosis than men, especially when they reach the age of 50.
Bone Health: Life Cycle Of Women
Bones are essential. They not only protect the vital organs from injury, but also act as a repository for essential minerals (such as calcium and phosphorus) which are released into the body for various uses. Yet, the bones get usually neglected.
A bone goes through a series of transformations, and the change continues in a person's lifetime. Doctors say, as a general rule of ageing, bones become weaker over time, and it varies from person to person.
Hormones play a crucial role in the onset of osteoporosis. In women, a hormone called oestrogen (or estrogen) is responsible for protecting the bones.
During puberty, when the bodies of young girls undergo a number of changes, the thickness of their bones also increases. "It is important for young girls to consume an adequate amount of calcium-rich foods during this period," says Dr Ashok Rajgopal, Group Chairman of Institute of Musculoskeletal Disorders and Orthopaedics at Medanta, Gurgaon.
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Women are at the peak of their bone health in their mid-20s, according to Dr Sachin Bhonsle, Orthopaedic Surgeon at Fortis Hospital, Mulund. "It is the right age to take care of bone health," he adds.
Like puberty, pregnancy and breastfeeding can also affect bone density. Some mothers experience a rare condition called pregnancy-associated osteoporosis where a woman’s bones become susceptible to breaking easily during pregnancy or after giving birth.
Dr Rajgopal says the bone mass lost during pregnancy and breastfeeding can be usually restored within a few months of the delivery. "A diet rich in calcium is important during pregnancy and breastfeeding as the infant derives its calcium from the mother," he explains.
As women age and reach menopause, estrogen levels drop, leading to a loss of calcium and other minerals at a rapid rate. Dr Rajgopal also sheds light on why women are more vulnerable to osteoporosis. "Women have smaller bones and lose them faster because of hormone changes that happen after menopause."
Knowledge Is Power
Menopause and age aren't the only factors that can hurt bone health.
Being underweight makes women more prone to developing osteoporosis. In fact, people on medications (steroids, antiepileptics and/or blood thinners) can also have weakened bones.
In most cases, women normally don't realise that they have developed the condition until it is too late. Also, they tend to ignore bone health until they experience severe symptoms.
Doctors call it a silent disorder as osteoporosis doesn't show any symptoms (at an early age) until an individual falls and has a fracture. The complications caused with hip or spinal fractures can even result in disability.
Stressing on the timely control of osteoporosis, the orthopaedic surgeon at Fortis says women with osteoporosis may need urgent surgery if they fracture their hip, wrist or shoulders, and medications don't help.
Another condition, called osteomalacia or soft bones, is caused due to low Vitamin D in the body. The condition causes pain in the bones and body and weakness.
The main reason for Vitamin D deficiency is the lack of sunlight exposure. "People who spend long hours indoors invariably are Vitamin D deficient, which can add to kidney and liver problems. These can further lead to weak bones," Dr Bhonsle says.
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During the pandemic, many women were forced to remain indoors and didn't have adequate exercise to keep osteoporosis at bay. Women who contracted the deadly virus also developed a bone-related complication, avascular necrosis (AVN), also called bone death. A simple medication can cure AVN, but Dr Bhosale recommends getting an early diagnosis.
He also lists long-standing chronic diseases like rheumatoid arthritis, thyroid disorders, endocrine gland disorders, tuberculosis and being bedridden due to malignancy or stroke as invariable causes of osteoporosis.
Gain The Upper Hand
The situation may appear scary, but the ultimate power lies in your hands. Experts insist that most of the causes of bone health deterioration are easily correctable.
Apart from age and genetic factors, which are not in our control, causes for the condition like low calcium intake, hormonal imbalances, gastrointestinal issues (due to low nutrient absorption rate), sedentary lifestyle, eating disorders and obesity can be managed through preventive measures.
First thing first, quit unhealthy habits. It's not doing you any good. Smoking and frequent intake of alcohol can affect bone health severely and decrease its density. "Getting rid of these habits has an immediate and direct benefit in more than one way," Dr Mathur says.
Meanwhile, early detection is also key in such conditions. Doctors suggest getting necessary tests to check the level of bone weakness.
While DEXA scan can help understand the degree of bone weakness, a low-dose X-ray can help examine the bone density. A low-dose X-ray of the hips and spine measures the calcium and other minerals present in the bones.
Although experts suggest starting screening at the age of 65, people with family history or long-term use of medications that can decrease bone density should get their tests earlier.
Once diagnosed with osteoporosis, long-term follow-up and treatment is required to keep bones in good condition. For women who experience early menopause, Hormonal Replacement Therapy can help after careful evaluation.
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For the longest time, the secret to a healthy life begins with food. Be mindful of what you put in your body, and you are golden.
Pick up a balanced diet that has a good amount of protein and calcium — the building blocks of bones.
Nearly 50 per cent of bones in the body are composed of protein. A drop in protein intake can decrease the body's ability to absorb calcium, further affecting the rate of bone formation. Have dairy products, eggs, seafood, poultry, legumes for your daily protein dose.
Some of the calcium-rich foods you must add to your plate are milk, cottage cheese, fish, green leafy vegetables and soy products, among others.
Vitamin D is very important for good bone health, and sunlight is considered to be one of the best sources of this important vitamin.
Dr Bhonsle suggests getting enough sun time. "Ultraviolet rays in the sun synthesise Vitamin D from cholesterol in the skin."
Just like protein, Vitamin D and calcium, Vitamin C also aids bone health. Vitamin C stimulates the production of bone-forming cells and increases bone mineral density, explains Dr Rajgopal. "The antioxidants in Vitamin C also protect bone cells from damage. Vegetables are one of the best sources of Vitamin C."
In addition to clean eating habits, staying active also helps in building a healthy life. Doctors say that weight-bearing exercises can help in managing a healthy bone weight.
Dr Rajgopal recommends high-impact and weight-bearing exercises as they can strengthen bones and help in the formation of new ones. "These activities increase the amount of bone created during the years of peak bone growth through childhood and adolescence."
Indulging in weight-bearing exercises like brisk walking, jogging, dancing and taking up a sport will go a long way.
However, Dr Mathur has a word of caution about exercises: "One must not go overboard with high-impact strengthening. The workout plan should be tailored to focus on strengthening the muscles of the legs and the back."
Take care of yourself. While the quote made famous in the Spiderman movies goes “with great power comes great responsibility”, remember that you already have a lot of responsibility. If not to anyone, to yourself.
Ladies, make no bones about this issue concerning your health.
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