SPEAKER_01 0:13

Hello and welcome back to Empower Your Menopause, where we dive into all things health hormones and happiness for women navigating midlife. It's myself, Coach James, and Coach Julie here. And today we're tackling a topic that doesn't always get the spotlight we think it deserves. It's one that we really talk about a lot, but it's absolutely crucial as you move through menopause, and that is the health of your bones. So here are a couple of sobering stats to start us off. First of all, in the first five to seven years after menopause, women lose about 20% of their bone density. That's one-fifth of your bone density. And then according to the Royal Osteoporosis Society here in the UK, half of women over 50 in the UK will break a bone due to osteoporosis. And those stats are probably married across the rest of the sort of like Western English speaking world as well. Don't panic though. There's lots and lots of stuff that you can do to protect your bones and stay strong in the long run. And we're going to dive into that kind of stuff in this episode. We're going to talk about exactly what happens to your bones during menopause, why it actually happens, how what kind of lifestyle changes can help strengthen them because as we said it's not too late, and how to take control of your skeletal health right now. So we're going to look at everything from nutrition and exercise to the importance of some testing that you can do. So let's bring Julie in then straight away. Julie, tell us what is it about menopause that leads to this depletion of bone mineral density. I wonder if you could we could start off there by explaining that to our listeners.

SPEAKER_00 1:50

Sure. I think the biggest thing that we don't that we women don't understand enough is what a protective effect estrogen has on our bodies. We have estrogen receptors everywhere. And when we lose that uh protective effect, as estrogen is spiking and dropping through paramenopause and then dropping off after the menopause day, we we lose a lot of those protective effects. So our bones are one of the key places where we lose that protection. And if we aren't doing the other things that we need to do to develop and maintain those, and as you like to say, put deposits in our bone mineral density bank to draw on later, um, that drop-off, that cliff can be kind of steep for a lot of women. So it it bones bee will become weaker um through this period because estrogen really does help to maintain bone density.

SPEAKER_01 2:50

Um I think it's really important to highlight here as well a couple of terminology things that we might want to just introduce to people. So the the one that we all know is osteoporosis, yeah. Brittle bones, they used to call it brittle bone disease many years ago in my in my mum's day. Um, it's the breaking down of bone over time. There is a precondition to that that is called osteopenia, which is sort of like the the precursor to osteoporosis. So just to highlight that then, and as Julie said, obviously, you know, osteoporosis is a real real challenge. It's one of those things we get so inclined to talk, I feel, about the symptoms that take place around the day of the menopause transition. So, sorry, if I've frozen for those of you who are watching on Zoom, hopefully my camera will come back on, otherwise, I'll switch to another camera. I just realized that that has actually frozen for us there. But one of the things that I, as I was saying, with the challenges around this actual um uh time is that we tend to focus on those immediate symptoms, things like hot flushes and brain fog and anxiety and all those increased things, which are obviously very, very important. But what we don't talk a lot of is about preparing ourselves in perimenopause, in menopause for that post-menopausal health, and that is in direct relation to that drop in in estrogen, that fall in estrogen, the protective effect that estrogen has on so many different areas of the body. So I think that that is a real real important thing to highlight here. So, Julie, talk to us a little bit about then this concept that quite often in people's heads, you know, once osteopenia or osteoporosis kicks in, there's nothing we can do about it. But that's not quite true, is it?

SPEAKER_00 4:42

No, it isn't at all. And you know, the bone matrix is kind of like it sort of looks like a sponge in the sense that it's got lots of cells and and uh a network of fibers and and such in between. But our bones are made up of a number of different minerals and uh and especially protein. But we don't we don't have to be um beholden to some idea that as soon as we hit menopause, it's all downhill. A lot of what we do, even as we're into osteopenia, um, can can be um slowed down and in some cases even reversed by lifestyle choices, like the kind of lifestyle habits we have, especially like alcohol and smoking, which we'll get into in a moment. Um, but your nutrition habits, your exercise habits, especially your exercise habits, because we we can add in simple things to our lifestyle and our daily lives that will actually help us build deposits into that bank. So we're not destined to just become brittle and frail and bent over and stooped over like some of these uh old women images that we have in our minds. Um not at all. It's there's a lot, there's a lot that we can do. And it it frustrates me to hear this myth. I've you know the I think the the difficult thing is that osteopenia doesn't have any symptoms with it. So we may not know that we're losing that bone mineral density until some of those symptoms appear in later stages or when we flip over into osteoporosis. So that's one of the reasons why it's so important to start thinking about these things now.

SPEAKER_01 6:27

Absolutely.

SPEAKER_00 6:28

And doing as much as we can.

SPEAKER_01 6:29

Yeah.

SPEAKER_00 6:30

Yeah.

SPEAKER_01 6:30

And as we've said many, many times before, when it comes to things like bone mineral density, it is like a bank. The more we can bank, or we can still healthily create bones, and we've got that protective effective estrogen, the better it will be for women in this age group. So let's talk then. First of all, let's dive into nutrition because I think that's really, really important, plays a really significant role. You know, the one thing we're always told when we were kids is you know, drink milk, eat cheese, have cottage cheese to help strengthen your bones because of the calcium content in those kind of foods. And calcium is really, really important, obviously, for bone mineral density and creating strong bones, but it's not alone, is it? It's not the only nutrient. So tell us a little bit, Julie, in your opinion, talk to us about some of those other um different minerals and that might be of importance here.

SPEAKER_00 7:26

Sure. And you know, one of the things that I find really interesting is there's a lot more research coming out now that shows that the calcium in dairy products isn't as bioavailable as the calcium in other things, like dark green leafy vegetables and nuts and seeds, where we can make a bigger impact through our diet. And of course, those things have many other benefits as well. But we we need minerals, especially the magnesium, gets a gets a bad wrap. And sometimes if we take in excess calcium without balancing those other minerals, magnesium, um, vitamins like D and K2, really important for the bone matrix. If we excess calcium and we don't get enough of the others, we can actually create other issues within our systems because our body needs to do something with that excess calcium. And sometimes that's I mean, that's a whole other topic of conversation, but balance is is key here. And and I think um focusing on yeah, on other other minerals, especially magnesium, because we've talked about this before that a lot of us are deficient and protein, of course, protein, protein, protein.

SPEAKER_01 8:35

Yeah, let's just go through some of those then. So, first of all, calcium, and I think it's really important to highlight here if you've not listened to our um episode from a couple of weeks ago, which was about vitamins and minerals and supplements, it might be worth going back and listening to that again, just so we can speak to or remind ourselves of the efficacy of having really, really good quality um supplements if we decide to go down a supplement route. So, not just buying things off the shelf in your local supermarket or your local high street chain supplement store, but actually seeking out things that are made to a higher quality, medical grade quality, that kind of thing. Calcium was one of the things we actually discussed on that podcast because some of the cheaper calciums, you might as well just go and get some chalk off the chalkboard in your school or in your kids' bedroom or whatever, and eat that. It's probably got as the the type of calcium that's there, is probably as good as the kind of stuff that you get in the cheap. So, if you want to get the top level things, magnesium, obviously, you know, we'd always advocate food first at fabulous beyond 40. One of the things with magnesium, as we discussed again in that previous podcast on vitamins and minerals, is the fact that our soils are really depleted in magnesium, and so our foods don't actually contain as much magnesium as they would have done to make it bioavailable just through food. So it's one of the things that if you are going to supplement something and pay out for supplement, a good quality magnesium is one of them. And there's our old friend, vitamin D seems to work with um estrogen in some way. Vitamin D receptors and estrogen receptors tend to be in the same parts of the body. Vitamin D, you know, if you're lucky enough to live somewhere where there's some really nice bright sunlight, you should get all the vitamin D you need from 15-20 minutes a day outdoors, and then vitamin K2 has to work with D in comparison, uh in conjunction, and that is why quite often you will see supplement formulas that are D and K2 together if you're looking for a good combo to add in from a supplement point of view. They'd be really, really you mentioned protein there, uh Julie. Let's talk about protein then and what's the role of protein in when it comes to bone mineral density and integrity, excuse me.

SPEAKER_00 10:50

Well, protein, of course, we need to maintain our muscle mass as well as our bone, our bone mineral, our bone mass, we'll say. Um, and the more muscle we have, we usually get through weight-bearing exercise, but the more muscle we have, the better protected our bones are going to be. And if our muscles are well protected and um well fed, that will have an effect on our bones as well. Um I freezing now, sorry.

SPEAKER_01 11:18

No, you're you're you're still you're still going. Yeah, we so apologies that we're having a few tech blips today. Yeah, but really, really important, as you say, for muscle and bone integrity. And you mentioned movement there, strength-bearing exercise. I think we've probably done enough that we need to do our nutrition for right now. Let's talk a little bit about movement for bone density. One of the things that we're often asked when we first start working with clients is why do you want me to lift weights? And there are a number of reasons, reasons for that. First one is muscle mass preserving muscle mass that depletes as we get older as well. And the second one is, of course, bone mineral density. It's one of the unless you're really into sort of like weight lifting or or or gym work, realizing that lifting heavy weights is actually protective of your bones rather than necessarily putting tons and tons of pressure on them is something that uh I think a lot of people don't actually actually realize. So when we tell people to lift weights in the gym, one of the things we one of the reasons we're doing that is because it does help with bone mineral density. And it doesn't just have to be lifting weights, things like walking and running, also very protective of your leg uh bones and the bone structure in your legs as well. But then resistance training, particularly upper body, is really really important for building uh bone during um during menopause. One of the things that's worth realizing is that when we put our bone under some kind of stress, and that stress usually comes from exercise, that is when they actually get stronger. So, Julie, tell people a little bit about what kind of exercise they might want to be doing in the gym when it comes to lifting weights and things like that. I wonder if you could take that on for us.

SPEAKER_00 13:17

Sure. Sure, sure. And there are there are seven basic movements that we that we do on a daily basis. And one of the things that we advocate for is functional movement. So we're not talking about lifting weights just for the sake of lifting weights, we're talking about lifting weights or strength training or resistance training for the sake of being able to do things in daily life better and retain our independence and retain our strength and posture and energy, and maybe even reduce the incidence of pain and stiffness as we age. Um, so those those movements are pull, push, um, squat, lunge, hinge, twist, and then gait, which would be walking. So those are things that those are movements that you do in every day. And if you want to be able to, for example, lift lift your groceries out of the car and carry them into the house without assistance, you're going to want to be doing pulling exercises. You're going to be wanting to strengthen different parts of your body. And I'll I'll just give an example. We have a basement that floods when we get a big storm. And I've been doing what's called a farmer's carry where you carry a dumbbell in each hand that's heavy and you carry them slightly away from your body and you walk and maintain a really tight core. And I don't enjoy them very much because I have issues with my shoulders, but I do them because I know they're important. And when our our basement flooded, my husband was recovering from surgery and I had to carry buckets of water after we used the shop back. And because of those farmers' carries, I was able to carry those buckets without hurting myself. And you know how much a bucket of water weighs. I mean, they're heavy. So it it's it's about doing things like that, um, being able to do those kinds of movements. And you don't have to use a machine or you don't have to buy a whole set of weights and set up a fancy gym in your house. You can use simple tools to do some kind of resistance training. But one of my favorite things is resistance bands because you can add on resistance as you get stronger with the multiple bands that you have. They're portable and you can get a pretty good set with handles and ankle straps and door anchors for about $25 to $30. So it's a nice way to do that if you can't get to the gym. Ideally, getting to the gym, you have much more opportunity for equipment and machines and access to personal trainer who maybe can guide you and give you points of on your form and that kind of thing because form is key. We want to stay safe. And so being able to do your strength training, whatever that looks like, in a way that's safe for your body is really important as well.

SPEAKER_01 16:05

Sure. I mean, there are books and books and articles and articles out there as well about just using your own body weight to do resistance. You know, you don't have to have an expensive set of weights, like Julie just said. Obviously, you know, if you go into a gym and it's well equipped and it's got all the equipment there for you, it's got a really wide range of weights from like half a kilogram up to 50, 60, 70 kilograms, then obviously then that is does make it a little bit easier. You've got to try and explore a little bit around movement patterns and different movements that will work for you if you're just using body weight. But you can you can do it, and you can do it really, really well by by having um just an inquisitive mind and going and looking for some of those body weight moments. But then, as you said as well, resistance bands really, really important. And I suppose the other thing as well is to think about flexibility, balance, things like that. Because when things start to become challenging, if we don't have a strong core, if we don't have have good balance, that is when we're more likely to have a fall. And if bones have if that bone mineral density has started to deplete, then those falls can lead to the actual fractures, and that is likely where that high percentage of women over 50 having a fracture, 50% of women over 50 having a fracture that we talked about earlier comes from. So incorporating some kind of flexibility and balance into there as well would be important. Simple things, you know, it's it's a cliche, but cliches are cliches for a reason. Stand on one leg while brushing your teeth. Do your left leg in the morning and then your your right leg in the in the evening when you're brushing your teeth to help with your balance. Do the occasional yoga class or the occasional Tai Chi class. Um, and then of course, for anybody who is interested in in the work that Julie and I do, we supply all our clients, whether they're one-to-one clients or members of our membership group, Club Fabulous Beyond 40, we supply them with exercise routines that help build on all these things as well. Now, I was going to talk next about testing and monitoring, but I think it's just worth going on to a little bit of a chat about some of the lifestyle factors and bone protection before we actually talk about testing. Because we've talked about what you should be doing, we've talked about the vitamins and minerals you know about, we've talked about the exercise you need to do. Before we go on to monitoring and checking, let's talk about the stuff that has an has has an impact. One of the big ones I tend to find is caffeine, and it's strange. There's uh caffeine does have an effect. Good quality caffeine in small doses is not an issue. Let's just clarify that. For either your menopause symptoms or for or for osteoporosis, but excess caffeine can have an effect on bone mineral density. Um osteoporosis are often seen as a female-led disease. But I've actually had in my clinic in the past one guy come to me and he came to me because he knew that I knew about osteoporosis because of my work with women in menopause, and he was a man in his 40s who had osteoporosis, and he was told by his doctor that it came from too much caffeine. So moderating your caffeine intake is really, really important, your coffee intake, I think, at this time, and then the other two things, of course, are alcohol consumption over consuming alcohol. I know it's nice, it sounds like we're the boost police once again, but it does have an effect and help accelerate bone loss, and we want to try and stay away from that. And then the other one, of course, is is smoking as well. Smoking also has detrimental effects. So caffeine, smoking, alcohol are three things we want to be looking at reducing if you partake in any of those to help protect bone mineral density as you get older. The other one is our other old friend. We've done lots of old friends today. We've done uh uh magnesium, we've done um alcohol. Let's now do stress, Julian, the impact stress can have on your on your bones. Talk to us about that a little bit.

SPEAKER_00 20:26

Oh my gosh. Well, uh chronic stress brings in elevated cortisol levels, which pile on um body fat, and it can excess stress can change a lot of things in our in our pH, in our body, and especially because excess stress can lead to some of these other habits like alcohol and caffeine and not sleeping. So we dose up on the coffee, and then we have some sugary carbohydrate laden treat to feel better and try to boost our energy. And when you add that to elevated cortisol levels, you're you're really creating a recipe for um for tri for trouble with with your bone, uh, with your bone density. Stress in general, I think, because it it tends to wear us down and we don't do the things that we need to do to maintain a healthy lifestyle. But again, those stress hormones, and it isn't just cortisol, we've got adrenaline and um epinephrine and norepinephrine, these things that are raging through our bodies that can throw our endocrine system out of balance. And when our endocrine system in general is out of balance, that also affects estrogen levels and progesterone levels and other things that again we're trying to preserve and help to maintain um our body in in a healthy state.

SPEAKER_01 21:52

Yeah. I mean we we talked about the protective effect of estrogen quite a lot across the whole spectrum of women's health. And obviously, things like HRT and things like that, which can help protect against osteoporosis because it's bringing estrogen back into back into a woman's body. There is that thing as well, of course, when it comes to stress, that when your ovaries stop producing estrogen, it's produced then in your adrenal glands. And obviously, if your adrenal glands are too busy looking after your stress, they aren't going to be producing any estrogen for you. So that is another challenge that comes well with the stress. So lots and lots of different things there that are a um that can be a challenge. So let's talk. We've talked about things we can add in, we've talked about things we want to remove if and where possible. Let's talk about bone health testing and monitoring then. So easy way to do it is to have one of those scales that sends up uh bioimpedance current into your body and will do things like your muscle mass, your fat mass, and your your bone mass. I would suggest that although it's worthwhile using that to keep an eye on what might be going on, that they aren't particularly accurate when it comes to bone mass. And then the gold standard is of course a bone density scan, which is called a DEXA scan, um, which can measure bone density. And I think that is something that you know if you can't get on your health service, it's worth maybe once a while, maybe once every couple of three years, going and doing a DEXA scan just to see where you are, and at least maybe have an idea where you are right now so you can uh monitor what's going forward. So checking it as regularly as you can afford to do it if you're paying for it privately, so you can catch bone um bone loss early would be a really strong recommendation there, I think.

SPEAKER_00 23:56

Yeah.

unknown 23:57

Yeah.

SPEAKER_00 23:57

As with most things, they say if you can't measure it, you can't manage it. So you won't know what you don't know until you until you have that information.

SPEAKER_01 24:06

Yeah. So let's ri do a quick little recap then before we head off. So some key takeaways. Bone health absolutely should be one of your number one priorities as you progress through perimenopause, menopause itself, postmenopause, and into your your later years. Because it's crucially, crucially important. Once you can't get around anymore, once you're having more challenges, once you aren't as stable, once your balance is not as good, you run the risk of really reducing your quality of life by having poor bone mineral density. So, really, really important. One of the reasons it drops off. We've talked about it a few times now, but I'll just go over it again. Is that protective effect of estrogen? Once oestrogen starts to go down on a consistent basis after menopause, then it is a real, real challenge. It's not the end of the world though, because there is stuff you can do about it right now. And Julie, do you want to just recap those few bits that we talked about then when it comes to nutrition and strength training?

SPEAKER_00 25:20

Yeah, sure. So paying attention to the things that you're putting into your body, avoiding things like caffeine and alcohol, or minimizing your intake. We're not here to judge, we want you to enjoy your life, but those are things that, especially at this phase of life, are going to do you fewer favors than we would like to think. And incorporating more of those leafy green vegetables, um, things like sardines and nuts and seeds, things that are contain a lot of good calcium for our body, as well as other minerals that will help, will go a long way. Um, dairy's okay, but don't rely on it as your only source. And then getting managing your stress, really, really critical. And then, of course, incorporating some exercise. And it doesn't have to be massive quantities. You don't need to spend hours in the gym. 30 minutes three times a week to do some strength training is ideal. And if that seems like a lot, then start with one day. As we always say, start with one step, pick one thing. We're giving you a lot of information, so don't try to do it all at once. And of course, we're here to help you if you need support with that. So don't hesitate to get in touch for us to guide you through that because that's it's important to set a path and set a goal and be able to do it consistently. It's much more important to be consistent with one or two things than to try to do it all at once and then quit.

SPEAKER_01 26:46

Yeah. I think it's important as well here just to put a caveat on all of this. If you're already into a journey where you've been diagnosed with osteoporosis, please, please, please see a your medical professional or a really good specialized personal trainer who specializes in people with osteoporosis before embarking on any heavy lifting or anything like that, because there can come to a point where bones have become so brittle that doing any kind of strength training can actually flip over and be detrimental. So you need to make sure that you're doing the appropriate strength training for where you are within all that. So let's just wrap up then by saying, before you say goodbye, if you've been affected by osteoporosis, if you need somebody to talk to about it or you've got another concern about your health and menopause, please drop us a line in some way. If you've got an issue or a topic that you'd like us to cover on the podcast, email Julie at fabulousbeyond40.com and we'll add it to our list of things to talk about. Because after all, we do this to empower your menopause, not our menopause, we've got loads of things to talk about, but it'd be miles better if we're talking about things that you wanted us to talk about or you felt as you needed help on. And then I think the other thing to just mention is that if you do need some one-to-one help or you just want to discuss things with either myself or Julie, in November we're offering our 40-free coaching sessions to celebrate Fabulous Beyond 40. So we're giving away 40 strategy calls, that's 20 each, um, throughout the throughout the course of November. The aim of these calls is to give you a roadmap to a healthier, better, more empowered you. To do that, we go through a three-step process. We talk about what your goals are, so where do you want to go to, what's helping you right now, and what's holding you back, and then we'll step in and we'll help you have some first steps to counteract those things that are helping you holding you back, so you've got a starting point to go ahead from the calls. So they're not sales calls, but of course, if you did then want to hear about how we might be able to help, we're happy to um explain that on the call or a later call, but you don't have to take up that at all. So these calls are really designated to help you. We'd advocate that you join us on one of them. If you want to book on one, they're already going fast. Simply visit freecall.fabulousbeyond40.com and we'll pop that in the chat below. So, Julia, have you got anything else to say before we uh head off?

SPEAKER_00 29:18

Um, just that I think it's it's a it's a really important topic, and I hope that this has helped you understand a bit more and to really take this seriously. And of course, we're here to help in any way we can.

SPEAKER_01 29:32

Fabulous. Okay, so stay fabulous. We will see you next time. It's been Julian James from Empower Your Menipause, the Fabulous Beyond 40 podcast. We'll see you soon. Take care.