Bone health is not something we think about until it starts to cause us problems.

We achieve peak bone strength by the age of 30. From midlife bone strength starts to reduce and at the time of menopause the rate of decline is the greatest.

Bone strength, which reflects bone density and bone quality, is on a continuum from normal bone to osteopenia to osteoporosis.

Osteopenia is characterised by reduced bone strength. Osteoporosis is defined as low bone strength. Both of these conditions, to variable degree, predispose one to sustaining a low impact (fragility) fracture.

Contributing factors such as family history, malnutrition, early menopause, autoimmune conditions and long term steroid use can play a role in reducing bone strength.

Lifestyle measures including a wholesome diet, high in protein and calcium, vitamin D3 (if indicated), regular exercise, not smoking and minimal alcohol play important role in promoting bone health.

Estrogen, as part of hormone replacement therapy, can be used to prevent or treat osteoporosis. Non-hormonal prescribed treatments are typically used once osteoporosis is established.