"Loss of bone density and strength quickens during menopause,” explains consultant rheumatologist Professor David Reid, who’s specialised in osteoporosis and bone densitometry for 30 years. “Women 10-15 years ago were more concerned about the link between menopause and osteoporosis, and bone clinics were full of women looking for guidance on Hormone Replacement Therapy (HRT). Nowadays, it tends to be mainly those who have already suffered a fracture who come in.”

Women lose about 1% of bone density every year after the age of 45

Women may have drifted away from HRT because the risks have been over-stressed, he says. “Most bone specialists would be happy to discuss relatively short-term HRT for women under 60 – it’s as effective as anything else.

The primary treatment for osteoporosis in over-60s advised by most guidelines are the bisphosphonates, which are also suffering from scare stories about long-term usage. We are beginning to see an increased number of fractures as a result of patients not taking drug treatment but the benefits greatly outweigh the very rare negative effects.”


Which women should have a bone density scan?


A DEXA bone scan is available at private clinics for anyone with concern re osteoporosis and often on the NHS for women over 50, who have strong risk factors such as having already suffered a fracture over the age of 50.

“Be aware,” advises Reid. “if your mother or grandmother became very stooped or lost height in older age, or can’t reach up to shelves they used to reach, they may have had spine fractures and you too may be at risk. Tools are available with some newer DEXA scanners which can measure directly if a fracture is already present or improve risk assessment”


What can be done to improve bone health?


Reid says that much can be done to improve bone health: a good level of Vitamin D is critical. “We just don’t get enough from our winter sun. A supplement of 400iu is a good standard, and those at high risk or already diagnosed with osteoporosis should be on 800iu.”

Most bone specialists would be happy to discuss relatively short-term HRT for women under 60 – it’s as effective as anything else.

Weight-bearing exercise is also useful for the legs, but “we’re struggling to think how to strengthen back bones,” he says. “They need to be strained a bit to improve the density.” There’s some early evidence that power plates and vibration therapy may help strengthen the spine, but more research is needed to prove their value”.


Learn more

The specialist women's clinic at 25 Harley Street is where leading medical consultants offer a discrete service from a single centre of expertise. The private clinic provides the very latest in high spec facilities, and covers the therapeutic areas of osteoporosis, menopause, gynaecology, rheumatology, endocrinology and emotional wellbeing. Patients can receive on-site diagnostics including the latest lab tests and a full body DEXA scan, all in a single visit.

Website: www.25harleystreet.co.uk