Today, I would like to discuss osteoporosis. We have all heard about this diseases, but do we know what causes it or what we can do to prevent it? One of the major side effects of surgical menopause is loss of bone density. Over time the loss of our bone mass can result in osteoporosis.
During our lifetimes we have a large quantity of years devoted to building our bone mass. In women specifically our bone mass continues to increase up until around our 30th birthday. During the time period of 0-30 years of age our bone mass increases faster than that of our bone loss. I am nearly 29, and this is the first I have heard or at least absorbed this information. My years of increasing my bone mass are all but up, so what do I do now? In most women, after the age of 30 you will begin the process of slowly loosing your bone mass. That is until you enter menopause. Once a woman enters menopause the slowly turns to rapid deterioration of our bones. This is bad news for women overall. With this little tid-bit of information it is not surprising that so many women end up with osteoporosis.
Here is my next question. How many women out there these days have a hysterectomy years before they would normally go through menopause? Ok you are not completely signing yourself up for osteoporosis many women can take hormone replacement therapy (HRT) to help with the rapid bone loss. So what are we losing by removing our ovaries that is vital to maintaining our bone mass? Estrogen, a hormone that helps prevent bone loss. You yank out the ovaries and you take the main estrogen producer out of our bodies. Like I said above, many women can take hormone replacement therapy to help with this but not all women can. This is a very important detail for carriers of the BRCA mutations. Why? Well, there are some types of breast cancer that have rapidly growing tumors when estrogen is present in our bodies. My mothers and Katie's tumors were both estrogen positive. As long as, their ovaries were in tact their cancer tumors had a chance of more rapid growth. This is also important when considering ovarian cancer. Studies have shown that some women who were taken estrogen as HRT after menopause had a higher overall risk of developing ovarian cancer. Those of us with a BRCA mutation are at high risk for both breast and ovarian cancer, therefore it is highly recommended for us to have our ovaries removed. This also means that once the ovaries are removed there will not be any estrogen put back into our bodies.
Back to osteoporosis though. I am 28 today, in July I will turn 29 so what can I do now to help myself knowing that I will be having a oophorectomy or hysterectomy before too much longer. Cody and I visited with a Gynecological Oncologist at the end of February. We asked alot of questions: from his recommendations to what will I be facing if we do go forward? Osteoporosis came up and he made me feel that my risk is manageable if I choose to be proactive. What does this mean? I need to start now, not after the procedure. My next move was research. I had a doctors recommendations, but what did the world wide web have to say. We have all heard of the next company and I found their website very informative. Boniva is of course trying to sell their product, but they are very informative about what osteoporosis is. "Porous bones," I don't want them so at 28 I am going to be proactive.
Step 1: Am I getting enough calcium?
http://womenshealth.about.com/cs/osteoporosi1/a/osteoporosispre.htm?p=1
The above website has the following recommendations for
"How much calcium do you need?"
Children from ages 1 to 10 - 800mg daily
Teenagers - 1200 - 1500mg daily
Women 25 - 50 - 1000mg daily before menopause and 1500mg after surgical or premature menopause
Women over 50 - 1500mg if not taking estrogen, 1000mg if taking estrogen
So lets ask ourselves, are we getting enough calcium in our daily diets? I'm not, and probably haven't been for some time. Especially since 28 months out of the last five years I have been pregnant or nursing and requiring an additional 400mg per day. That's not all though, we cannot just go out and buy a single 1000mg calcium supplement to take once a day. Our bodies can only absorb 500mg of calcium at one time, so we must take two or more supplements at different times throughout our day. Next we must be very specific in what supplement we choose. Not all supplements are equal. We need calcium carbonate, and on top of that research now states that we need vitamin D3 in our supplement to allow for absorption of our calcium. Uugh, ready to scream yet?
Ok, so we have faced our calcium shortage woes, but there is still more work to be done. I would rather not spend the rest of my life with a pill box in tow. Ready for another question. What can I do to reduce my chances of another pill? Exercise, specifically weight bearing exercise. This does not mean weight lifting. Walking, low-impact aerobics and others are recommended.
Step 2: Exercise
I love taking the kids for walks but is an occasional walk really going to make an impact. The gym would be extremely beneficial, I'll be honest though it is not convenient and there may be weeks that it does not happen. What to do, what to do? Enlist someone to keep you accountable, and who better than the person I live and share my life with. An elliptical will be part of our home soon, not just for me but for him too. He will know if I have met my quota for the week, and he can also distract the kids long enough for me to get my workout in. Our plan is in the beginning stages, but we will be doing it for each other.
Step 3: Keeping an eye on things
Either before, or immediately after the hysterectomy I will be undergoing a bone density scan. My doctors and I will be monitoring my progress. As long as, I am able to reasonably maintain my bone mass I will be able to avoid the pill. At some point in time there may come a day that the pill is necessary, but my goal is to put it off as long as possible.
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