November 4, 2025 • 38 mins
Changes in menopause are more than just mood and temperature swings; it is a rewiring of bone biology. The Besties sit down again with Dr. Toni Otway, a New Jersey Board Certified OB-GYN physician, to unpack how falling estrogen levels accelerate bone loss, why height can shrink over time, and what it truly takes to prevent fractures that derail independence. Instead of chasing a perfect bone density number, they focus on a smarter target: fracture prevention through timely hormone therapy, evidence-based medications, and daily habits that strengthen bones and reduce falls.
Dr. Otway breaks down the science of menopause-associated bone health in plain language—how bones remodel, why vertebrae compress into microfractures, and the real stakes of a hip fracture.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
SPEAKER_03 (00:02):
Hey Ant.
Hey Les.
How's it going?
SPEAKER_02 (00:05):
It's going well.
Good.
We got company.
We have company.
So I'm going to be on my bestbehavior.
Actually, no, we don't havecompany today because she's
already family.
Yes, thank you.
On our podcast multiple times.
And once you get past the firstepisode of shenanigans, you're
(00:26):
in.
You're in.
So I want to say welcome toanother episode of Black Boomer
Besties from Brooklyn.
SPEAKER_03 (00:36):
Hey folks, I'm Angela, and that's Leslie, my
best friend of almost 50 years.
We are two free-thinking60-something-year-old black
women, and we've decided to bereally intentional about
inviting joy and boldness intoour lives.
We want you to come along withus.
We want you to be on your ownjourney of boldness and
(00:59):
joyfulness.
So today we have Dr.
Tony Otway back.
Do you remember her?
Yes.
She has been here before.
She is an honorary bestie.
And she's here to talk about yetanother of the myriad of aspects
(01:20):
of menopause.
She is here to talk about yetanother.
SPEAKER_02 (01:26):
So Dr.
Tony Otway, she's a licensedobstetrician and gynecologist in
New Jersey.
And we are blessed to have herhere to continue our series A
Year in Menopause.
We thought that it's importantto continue to bring this
content to you because menopausetouches everyone, whether you
(01:50):
are a female, a male, whetheryou have a uterus, whether you
know someone or love someonewith a uterus, menopause will
affect you in ways that youwould be shocked.
Hello, my dear.
unknown (02:04):
Hello.
SPEAKER_01 (02:06):
Welcome back.
Thank you.
Thank you for having me back.
I know it's been a little bit oftime, but uh yes, we're racing
to the end of the year and we'vegot some more things to talk
about with menopause.
So um let's get to it.
SPEAKER_00 (02:20):
Let's get to it.
SPEAKER_02 (02:23):
So we've talked about some of the um
cardiovascular changes um inmenopause.
And one of the things that we'vementioned that's really, really
important is how menopausetouches every aspect of our
human beings, every system,every organ.
(02:44):
And very often we don't hearabout things other than hot
flashes, perhaps.
But um, we have Dr.
Tony here to talk to us aboutother aspects of menopause.
SPEAKER_01 (02:55):
Right.
So today I want to go over bonehealth.
Um, you probably know a bit moreabout with called osteoporosis,
but they're trying to changethat name uh to encompass uh
everything that should be doneto help maintain your bones.
Um so you know, just to recapagain, menopause is uh classi
(03:17):
you're classified as menopausewhen you're one whole year
without your periods.
Average age in this country is51, and you've got to understand
that at least 40% of your lifewill be in those menopausal
years, especially because womenlive till about average age,
late 70s, 80s.
So you know, if you're becomingmenopause at 50-51, that's
(03:40):
almost 50% of your life is inthis stage.
Um so let's talk about bones.
Um let's talk about bones.
Let's talk about bones.
So you you know, you'll you seewell, you used to see a lot of
you know, you know, women who,you know, as they get older,
they start to shrink down.
And that's one of the thingsthat um when you go for your
(04:01):
yearly, um, they're doing moreand more is actually measuring
your height.
Um just to make sure that youare so if when you go for your
yearly and exams um with yourprimary care, make sure they're
measuring your height.
Uh just to see if you're losingheight at all.
So this yeah.
SPEAKER_02 (04:19):
That's funny that you mentioned that because I've
noticed that at the tender ageof 63, I've lost probably about
an inch.
Yeah.
Really, Laz?
That much?
Yeah, I don't think I'm 5'8anymore.
SPEAKER_01 (04:32):
Woo! Oh wow.
Yeah.
So um the whole thing with boneis bone is like it is a dynamic
structure.
It's constantly breaking downand building up, breaking down
and building up.
And where as where estrogencomes into this, it helps to
slow down that that breakdown.
So you continue to build, andestrogen keeps maintaining your
(04:54):
bone, uh, the strength and thestructure and the density of
your bone.
So once you lose that, um it'scontinuing to break it's it the
estrogen.
Um, once you lose the estrogen,your bone just continues to
break down faster than it'sbuilding up.
And that's where you get thisweakness in your bones, you get
loss of the density and thequality of your bones.
(05:18):
So most medications that theyput you on these days, if it's
not estrogen, it's othermedications, is to help stop
that breakdown and help tomaintain.
So just you know, go ahead.
You had a question?
SPEAKER_03 (05:30):
Yeah, I listen, uh, you it just out the gate, as we
say, out the gate, yeah.
I'm learning something because Inever think of bone as something
that is in change, in flux.
Oh, yes, constantly.
(05:52):
Constantly.
Constantly in flux.
So constantly in flux.
In incredible.
Because what that means to me isthat there is something that one
can do to affect this thingthat's constantly in flux.
We want it to flux up, not flux.
SPEAKER_01 (06:08):
Exactly, right.
SPEAKER_03 (06:10):
Exactly.
Yes.
So so wait, one other one otherthing I wanted to mention, like
um we we we so we think aboutosteoporosis and kind of maybe
like a hunching over as as oneages.
And I wanted to talk about, Iwas listening to our friend um
(06:34):
Kim Coles has this podcastcalled Reliving Single.
And they had um they had a gueston and they were talking about
menopause and aging and so on,and um how it changes the body.
And Kim mentioned that she is umdoing some hormone replacement.
(06:59):
And I've never thought aboutthat.
I've never considered it becauseI did not experience menopause
um in a in a in a disturbing wayat all.
I had hot flashes, but just likemy mother, it was very mild, um,
an annoyance, but none of thekind of horrible things that I
(07:21):
hear people experience.
And so I don't think aboutthings like um HRT, hormone
replacement theory, but when Ithink about my bones, I want to
think about HR.
Do you know what I mean?
Yes, so that was the first thingthat comes to mind is that we
have this idea that because weattach menopause to hot flashes
(07:42):
only, only and and mood, and weeven make fun of it in those
aspects, right?
We we we make fun of itourselves.
It's not only that other peoplemake fun of it and point and
direct it to us, we put levityaround it also.
Um so I never think about it,but the more that you expose me
(08:04):
and us, everyone out there, tothese the connection between
estrogen and these other systemsin our bodies, I am just blown
away.
SPEAKER_01 (08:15):
Right.
And and the the sad thing isthat um, you know, I think I'd
I'd mentioned this before thatit's it's not a subject that's
really taught in medicalschools, it's not a subject that
was really taken seriously.
Um, so with there's a wholegeneration of people when they
(08:36):
first came out with estrogenreplacement and then they scared
everybody into not taking it,there's been a whole generation
that's actually lost the benefitof using estrogen and hormone
replacement therapy because ifyou're not starting it within,
you know, the five to six, sevenyears after menopause, yeah,
it's really not a good idea tostart using it at this late
stage of the game.
(08:57):
So it really has to be somethingthat's done very close to when
you go into menopause toactually reap the benefits of
maintaining this your estrogenlevels.
That's so estrogen.
It is.
It's it is a whole generationhas been lost.
Oh my god.
Um because of the WHO study andand everything that scared
everybody.
(09:18):
So it's only these past coupleyears that we've started to push
for more um research, moreeducation, um, and pushing women
to actually try and learn andmake sure they understand what's
going on, that things havestarted to change.
Um, but again, it's a wholegeneration that's been lost to
going without estrogen.
(09:39):
Um but there are other thingsthat we can do to help uh
maintain our bones at this stageof the game.
SPEAKER_02 (09:45):
So there's a couple of things I thought of while you
were speaking, and this isreally I love the fact that
we're bringing the conversationto the public.
I met a woman, um, she wasactually my manicurist um a
couple of weeks ago, and we gotto talking.
She was a black woman who toldme that um she didn't have any
(10:08):
children.
I think she was forty-five orso, she didn't have any
children, and she said,regrettably, I went into
menopause early in my 30s.
Wow.
And she said, listen to this,she said, I found out later when
(10:28):
I could no longer have children,that my mother went into
menopause early.
And my grandmother went intomenopause early.
Oh wow.
But because we don't talk aboutthose things, her mother did not
have that conversation with herand give her the opportunity
(10:51):
perhaps to start childbearingearlier.
SPEAKER_00 (10:54):
Right.
SPEAKER_02 (10:55):
And she only found out too late.
So the fact that we're talkingabout this is just so important,
you know, to stimulate dialogueand to take the taboo off of
something that's just a naturalpart of everyone's life.
SPEAKER_00 (11:11):
Right.
Right.
Absolutely.
SPEAKER_02 (11:13):
I just I just here's here's the teacher in me and the
doctor in me also.
I just want to go back a littlebit and talk about what we call
the pathophysiology of bone lossand and getting shorter and all.
And what that means is how ithappens, what happens in order
to make these things happen.
Well, remember we talked aboutwith estrogen, it causes the
(11:35):
makeup or the matrix of thebones to get weaker.
SPEAKER_00 (11:39):
Right.
SPEAKER_02 (11:40):
And the word osteoporosis actually means
osteous bone and porosis isholes.
So it instead of the bonesforming solidly, it forms
loosely like a sponge.
Right.
So clearly the bone is not asstrong.
SPEAKER_00 (12:00):
Yeah.
SPEAKER_02 (12:00):
So if you so now you have weaker bones.
So when you fall, you're moreprone to breaks and fractures,
etc.
However, here's how you getshorter, and women and people
have that hump.
The vertebrae, the bones in theback, the spinal column, they're
obviously made of bones.
But let's say that bone getsweaker, right?
(12:22):
So they're stacked on top ofeach other.
Yep.
And the ends of the bones startlosing their density, and it
presses shorter and shorter.
And you get these small, whatthey call microfractures a
little bit.
So the end plates are likegrinding and getting shorter.
(12:43):
Instead of being nice and fulllike this, they become that's
how we lose our height.
Heights, yeah.
The bones collapse collapsedown.
Right.
And and the curves develop whenthe front, let's say, lose more
than the back.
So now it goes like this.
(13:04):
Right, exactly.
Instead of like this, you'relike this.
That's how you get these curves.
Right.
SPEAKER_03 (13:10):
Let me tell you, you went from medicine to
engineering.
SPEAKER_00 (13:16):
Now, speaking your language.
SPEAKER_02 (13:19):
So the point is, by the time you see an elderly
person who is actually stooped,we can't tell them straightened
up or whatever because they nolonger have the physical
structure and ability to standup.
Their bones no longer areperfect uh squares or
rectangles.
(13:40):
Exactly.
So as Dr.
Atwe is saying, we really needto start these restorative
processes early.
SPEAKER_01 (13:49):
Early.
Absolutely, absolutely.
And take it seriously.
Take it really seriously.
Just give you to give a fewstatistics.
Worldwide, there's about 8.9million fractures annually.
That's like somebody having a abreak every three seconds,
whether it's a hip, whether it'sin the back.
Um and uh it's it increased moreif you've had a previous
(14:11):
fracture.
Um and the hip fractures are theones that are the most and the
worst.
They cause the most problems.
There's about if you have a fithip fracture, 10 to 20 percent
of women go from being like afunctioning person in the
community to becoming having togo into a long-term uh dwelling
(14:31):
because they cannot functionanymore.
Just from a hip fracture.
Just from a hip fracture.
We're not even talking about theother ones, we're just talking
about the hip.
Why?
So it's it's a pro it's aprofound loss of function.
Yeah.
It's not just you breaking yourhip.
Like when you were younger, youcould break a hip, whatever.
But once you get older, it's aprofound loss of function.
40% of people are unable towalk, 60% need assistance within
(14:55):
the first year.
Uh, and and it's weird becausemore women are scared of breast
cancer than they are of having abone fracture.
And if you look at if if youlook at the statistics with
breast cancer, um, if you catchbest breast cancer early and it
hasn't spread and it's verylocal, um, five-year survival
rate is in is in the high 90s.
(15:17):
Um whereas the the morbidity,mortality, the death, and the um
illness from having a bonefracture is so much worse uh,
you know, than that it is forhaving breast cancer.
So we need to be more aware ofthese things, yeah.
So sit in that for a minute.
SPEAKER_02 (15:36):
Uh all this is from a lack of education.
A lack of education.
Who knew?
SPEAKER_01 (15:42):
You know, absolutely, yes, yes, yes.
SPEAKER_03 (15:45):
So you you mentioned we, you use the the word we in
describing how the things arechanging in terms of um um being
more aware and educating more.
Who is the we?
Who's taking who is leading thecharge in changing how menopause
(16:06):
is viewed in terms of someone'swhole life, not this comical um,
you know, um, we don't need tohear about that.
It's all about your mencies andthat's it.
And right, you know, um who isleading the charge?
I want to like give them flowersor something.
Well, we're talking to one ofthem.
(16:28):
Right.
I love that.
You get the flowers.
SPEAKER_01 (16:33):
You get the flowers.
And I think more and more, Iremember I said there was this
whole lost generation of womenthat are not being treated for
this.
And I think more and more ofthose lost generation physicians
are coming into this world andsaying, well, wait a minute, you
know, we need something, andthis is what's pushing um a lot
(16:54):
of, you know, more medicalschools are teaching it, there's
more research into it.
So I think it's more of thewomen that are um experiencing
this and and demanding uhanswers and demanding some help.
SPEAKER_00 (17:09):
Yeah.
SPEAKER_01 (17:10):
You know, so it's it's not impossible to slow down
the process.
And the process is notnecessarily to build your bones
back, it's to prevent preventfractures.
That's what we're trying to do,and that's the new train of
thought, is not necessarily tojust to build bones back up
again, it's to help preventfractures, preventing from uh
(17:32):
continuing to lose and make youknow by making your bones stable
so you're not losing anymore,and doing other things to help
um, you know, maintain yourheight, maintain your bones,
whether it's through diets,whether it's through exercise,
whether it's through otherthings other than estrogen.
So it's really about it's reallyabout preventing fractures.
(17:55):
And this is why they're sayingit's they're trying to move away
from that word osteoporosis tobone health, because it's it's
encompassing a lot of differentthings to try and maintain your
bones.
Wow.
SPEAKER_02 (18:08):
You know, I'll tell you, I see an integrative
medicine doctor, and I went tothem their practice because of
uh menopausal symptoms of hotflashes and all, not
necessarily, not at all relatedto bone health or whatever.
And while I've been on HRT nowfor about a year and a half, um,
(18:31):
helpful with the symptoms of umhot flashes, but on my last
visit, she sent me for a bonescan and said, it's time I want
you to get a periodic bone scanjust to check on the fitness of
your um bones and what have you.
And, you know, proverbially, Ialways in medical school, I know
(18:54):
I was taught you mo uh most ofthe population prone to
osteoporosis are the people umAsians, people from the uh
Eastern Europeans and small,frail, um blonde people um that
I never really thought thatosteoporosis was a problem in
(19:15):
our community.
SPEAKER_01 (19:17):
Right, right, right.
Because you didn't see as manyyou didn't see as many um black
women with those issues ofheight, loss of height, and the
hunching over, but you see uswith those fractures.
We do have those fractures.
Yes.
You know, we it it does it doesincapacitate us as well.
So um we are affected.
SPEAKER_03 (19:37):
I'm about to dig up my waist right now.
I'm about to start like on thiscall, I'm gonna start lifting.
Yes.
I mean, really, that's that'sthe shift.
That is what this conversationis moving me towards um taking
action because these are it whatthe what the what now?
(19:57):
One thing that I did to do,Tony, since the last time we're
here, I certainly did go out andget those Syndrome.
SPEAKER_01 (20:06):
Okay, good.
Like the next day.
Good for you, good for you.
Just a little bit, yes?
Every little bit helps.
SPEAKER_02 (20:13):
Every little bit helps, every little bit helps.
And I've started weight trainingbecause I've learned that since
June, I've heard that weighttraining, wait, wait, wait, let
me just Oh Lord, over here.
Wait, wait, yeah, no, no, no,don't I've heard that if if you
(20:34):
if you do weight training, notnecessarily to bulk up, but that
it is helpful in bone health.
SPEAKER_01 (20:41):
Absolutely.
And and please, there's amisconception that you'll bulk
up um doing weights.
We could we could never, aswomen, or we could never lift as
much weight to bulk up.
So um don't get uh, you know,don't think that.
But the the the the exercisepart of it helps to stimulate
bone formation because what itdoes is it stresses it's it's
(21:04):
almost like a mechanical stresson your bones when you're doing
weights and you're doingexercise, and that helps to
stimulate, helps to stimulatebone formation and decrease
bone.
SPEAKER_03 (21:16):
Osteoblastic.
SPEAKER_01 (21:18):
Right.
SPEAKER_03 (21:19):
I bet I bet you I'll be lifting those weights
tomorrow.
I bet you I promise you.
I feel like that's very thing inthis moment.
This is changing me.
I promise you.
SPEAKER_02 (21:32):
This is but I'll tell you, with these
conversations as with others,very often you just need to make
one or two changes.
Exactly.
SPEAKER_01 (21:42):
Yes, absolutely.
SPEAKER_02 (21:44):
I mean, in addition to bone building that weight
training does, what it also doesis it helps us with balance and
pro what they callproprioception.
Right.
And remember, when we get older,sometimes we're less steady on
our feet.
Yeah.
We uh don't see as well.
But all of that is related to anuneven muscle tone.
SPEAKER_00 (22:07):
Right.
SPEAKER_02 (22:08):
So if we continue, you know, keeping up our muscles
and our muscle strength, even ifwe do happen to have falls,
because I know I'll fall, but Iwant to be able to pick myself
up off the ground and not fallin a way where I'm breaking, you
know, these bones.
SPEAKER_01 (22:28):
Absolutely.
Absolutely.
Oh my goodness.
I know.
Okay.
So again, it's uh it's all aboutpreventing the fractures.
That's what we need to worktowards.
So um, so what do we do?
We um, you know, uh diagnosingit is based on a is a based on a
bone scan called a DEXA scan.
(22:50):
Um and what they do is theymeasure the bone density and
they compare it to a healthyyoung person.
Um and there's two two wordsthat most people probably know
there's osteopenia andosteoporosis.
So if you think of osteopenia asslightly bone slight bone loss,
(23:11):
and then osteoporosis as severebone loss.
So that's how people need to tothink of it.
So um, and usually if you'rejust in what they call slightly
bone loss, when you go throughmenopause, it'll take years
before you get to osteoporosis.
But if you're on that borderlinewhen you go into menopause, that
(23:33):
tipping you over into the severecomes very, very fast.
So again, it's something youneed to start doing from way
back when.
From way back when.
Just like everything I say.
Not June.
SPEAKER_03 (23:49):
And not June.
SPEAKER_01 (23:51):
Not too June.
Oh my goodness.
Not June.
It's all about, it's all aboutmaking sure you're doing these
things from way, way, way back.
SPEAKER_02 (24:07):
But you know, this is a concept that we talked
about in previous podcasts, andit's a common thing going around
in the medical community abouthealth 3.0.
Right.
If we want to get to a healthy70 years old, we really have to
start in our 20s.
And surprisingly, it not onlyinvolves um nutritional eating
(24:30):
and keeping your body um well,but it also involves maintaining
restorative friendships andrelationships and financial
health and wellness.
It's the combination of all ofthese things that it looks like
my video is stuck, but it's thecombination of all of these
(24:51):
things that is going to get usto a healthy 70 years old if we
pay attention to all of thesethings.
SPEAKER_03 (24:58):
Okay, but wait, hold hold on, hold on.
I get it, I get it.
Shame on me.
However, it's never too late tostart.
Thank you.
Can we get to that?
It's not too late to start.
Okay.
Listen, I'm not about to just gogo get into bed and and and stay
there.
So what what do we do at thetender age, as Leslie always
(25:22):
says, the tender age of 63.
Yes.
SPEAKER_01 (25:26):
Okay, so let's just talk about when you should
actually be tested.
You should definitely be testedwhen you're over 65.
Okay.
Uh, under 65, if you have someof the risk factors uh that
don't not include in menopause,some of the other risk factors
that I'll go over.
Um, or women that have had likefractures under 65, uh, who
smoke, who have who takesteroids, who have autoimmune
(25:50):
diseases, all these people,women that are menopausal under
65, should really have abaseline bone density scan.
SPEAKER_00 (25:56):
Okay.
SPEAKER_01 (25:57):
And they usually measure these bone densities
every two years because it itkind of takes that about that to
see any significant changes.
Oh, okay.
Um the other thing is that itused to be that you would just
take your bone density scan andthey would just read, you know,
the numbers from the bonedensity and and and treat you
(26:19):
based on that.
But there is a new, well it'snot really new, but it's
something that you should alsohave done.
It's called a frack score, andbasically it's taken into
account bone density, it's justone portion of uh measuring your
risk factor.
It's fracture risk factor, riskrisk assessment, I should say.
(26:40):
So it's a it's a frac score, andthey take into account your age,
your weight, your height,whether you use tobacco, whether
you use steroids, whether youdrink alcohol, whether you have
autoimmune diseases, rheumatoidarthritis, lupus, sickle cell.
Um, if you have family historyof people women that have
fractures early, um, and itgives you a 10-year uh risk of
(27:04):
hip and other bone fractures.
So it's not just about takingyour bone density scan anymore.
So this is something when you doa bone density, you should ask
your providers or your doctors,what is my risk?
What's my frack score?
Should I be on treatment?
Okay.
So two things you need to dofrom now.
You need to make sure you'rebeing measured when you go for
(27:26):
your primary, for your yearly,and you need to make sure you
have you get your frac score,not just the bone density
number.
It's there's a whole thing,which is again bone health.
All those things I mentioned,all bone health.
Because all those things need tobe taken into consideration to
calculate your risk.
(27:47):
Okay.
Wow.
SPEAKER_03 (27:48):
Listen, my page is almost filled here.
I'm over here taking notes.
You have no idea.
This is I tell you, this episodeis for me.
Okay.
SPEAKER_01 (27:59):
I'll share it with everybody, but I'm just so some
of the things that we that youneed to do, the easiest things.
One, it well, that the the mostthe best thing to do for when
you're going through menopauseis always hormone replacement
therapy, estrogen.
But again, this needs to bestarted sooner rather than later
when you first getting intomenopause.
(28:21):
Even if you're starting to seeirregular periods, it's best
time to start anything if you'regonna usually once you're five,
six, seven years out, it's notum you there's other issues that
may be going on, cardiovascularproblems, if you're diabetic,
all these other things thatcould come into play.
Um, so estrogen is always thenumber one.
In terms of diet, you shouldneed to make sure you're taking
(28:42):
enough calcium in every day, atleast 1200 milligrams per day.
Um, and there's two forms ofcalcium: there's calcium
carbonate, which should be takenwith food such as which is like
tums, and then there's calciumcitrate or citrical.
And most of these are over thecounter.
So it's 1200 milligrams ofcalcium per day.
You're getting that answer.
(29:02):
I don't have my pen handy.
Oh, I got it.
Oh, I got it.
Vitamin D, you need to begetting four to eight hundred
international units per day tohelp prevent uh, you know, falls
and uh sorry, uh help to preventfractures.
Um and this needs to be divideduh to increase your absorption.
Because if you take too much, ita lot has to do with your GI,
(29:25):
um, what's going on with yourstomach.
So um sometimes it's a littlebit more harder to absorb that.
So you know where we get ourvitamin D from?
The sun.
The sun.
But the sun may not always begood for us either.
Um and I'm gonna talk about ourskin in a little while.
So um things that um haveincreased vitamins in, you know,
(29:45):
we have fortified uh milk andcereal, all these things have
added um vitamin D in.
Um, and just have a healthydiet, egg yolks, liver.
I don't know if anybody likesliver, but whatever.
Um So uh so all these thingsthat have extra vitamin D that
they have put into our foods.
(30:06):
Um but if we have uh if wecontinue the way we're going,
who knows what our foods aregonna be like in the future.
I don't know.
Yeah.
Maybe I'll follow you where yougo.
Um so other things that we needto do, which we talked about was
r uh regular weight, um weighttraining, muscle strength, even
(30:27):
if it's just walking, uhtreadmill, uh, you know, you get
on your peloton, those these areall the things that help with
muscle strength.
And again, it's it's a stressor.
So it's helping to build thatmuscle or those bones up.
Um again, quit smoking if you'resmoking and moderate and try and
decrease your alcohol intake.
(30:48):
So um these are some of thethings you can do to uh just on
a day-to-day basis.
Um and then there's also themedications that you can take.
You hear about and all thesemedications work the same way as
estrogen, which is to helpdecrease um the reabsorption of
the bone.
It's called reabsorption.
(31:10):
Um things like your phosmax,your actinel, your prolia.
Prolia is an injection, allthose other ones are um
medications you take by mouth.
Um so there are other things,you know, there are pills that
you can do if you're not takinguh hormone replacement therapy.
SPEAKER_02 (31:29):
So the main thing is to get it checked.
Get it checked first,absolutely.
Start the process as early aspossible so you know what your
numbers are and your riskfactors.
Right.
I love that.
So, Dr.
Tony, in the in the we have justuh not too too much longer.
Um t tell me, does the menopauseaffect loss of estrogen affect
(31:53):
the skin?
SPEAKER_01 (31:54):
Oh, absolutely, your skin and hair.
But let me just say somethingreally quickly about the bone
still.
Um, if anybody's had bariatricsurgery, um that also will
increase your bone loss becauseyou're not absorbing your
calcium, your vitamin D.
So you've got to make sureyou're on top of that too.
Okay.
Good point.
Good point.
Skin, estrogen helps tostimulate the collagen in your
(32:15):
skin, which keeps it elastic andstops that whole droopiness and
those wrinkles.
It keeps that elasticity.
Yeah, I have oh yeah, like this.
Sometimes do you ever stand inthe door like this?
And you're like, yes.
SPEAKER_02 (32:29):
I'm like, wait, wait, all I need is a piece of
tape.
SPEAKER_03 (32:37):
I'm like, what fingers?
Yeah, I don't see any fingers.
SPEAKER_01 (32:41):
I stand there sometimes, and I'm like, geez,
when I was like when I was 20,this used to be all the way up
like so good.
Oh Lord.
So collagen, okay collagen,hyaluronic acid.
It's another one stimulateshyaluronic acid.
(33:02):
And hyaluronic acid helps tokeep the skin um moist,
maintains the moisture in yourskin.
So you see all thesemedications, um, you know, all
these hyaluronic acids that youcan put on.
I use them.
Um all this kind of stuff,right?
So estrogen also decreasesinflammation, which causes, you
(33:24):
know, bruising or wrinkling andit helps with wound healing and
prevents antioxidant damage fromthe sun.
So you have to be very careful.
So even though you need the sun,you have to be careful with the
sun.
Just because we're black people,too, you need to make sure
you're still protecting yourselffrom the sun.
Yes, uh, making sure you usesunscreen.
Okay.
(33:45):
So you should really usesunscreen, uh, especially
though, those people in thesouth, you need to be using the
sunscreen.
So and then it also with thehair, it stimulates the hair
follicles and maintains it keepsyour hair in that state of
growth.
Always, it's always growing,you're losing it, growing.
Once you lose that estrogen,that growth phase just like
(34:06):
drops off.
That's when you'll see thethinness, thinning, um, the
brittleness.
Yes, that's what estrogen doesfor you.
So estrogen is like this thismagic pill.
It's a magic, magic, magicbullet.
Absolutely.
Absolutely.
So, yeah, those are the things.
And those uh estrogen is great,but you know, like I said, that
(34:30):
we've lost a lot.
So um, but another thing I alsowanted to make sure I talk about
with um with the bone loss, itto help with um not getting a
fracture is making sure thingslike getting your eyes tested,
making sure you don't haveobstacles in your house, make
sure you don't have rugs thatdon't, you know, that that have
a backing on that won't slip.
SPEAKER_03 (34:52):
Yeah.
SPEAKER_01 (34:52):
Making sure you in the wintertime you're clearing
off that black ice, you're notwalking out there blindly.
SPEAKER_02 (34:58):
Do you know what the number one of the number one
reasons I have patients comeinto the aura for fractures?
SPEAKER_00 (35:06):
Walking their dogs.
SPEAKER_02 (35:07):
Their dogs on the right walking, the elders walk
their dogs, and the dogs gettangled, the little dogs get
tangled in their legs.
Right.
How many times has Simba trippedme up getting in between my
legs?
Yes.
Yeah, so people have to be verycareful about that.
You be careful about how oftenthat happens.
SPEAKER_03 (35:26):
The world is dangerous out there.
SPEAKER_02 (35:31):
And not even just we need to just sit on our couch
with the weights.
Oh gosh.
Oh my goodness.
Yeah.
That is.
Yeah, absolutely.
Absolutely.
You know, going to the days, Ireally felt badly for the lady
(35:54):
that said her mother just nevertold her something.
So, you know, that was agenerational issue for her.
SPEAKER_00 (35:59):
Yeah.
SPEAKER_02 (36:00):
And she really had a lot of resentment and uh over
the loss of the ability, youknow.
She said had she known, shewould have had children when she
was much younger.
SPEAKER_03 (36:10):
Right.
Well, her mother didn't knoweither.
That's why this conversation hasto be intergenerational.
SPEAKER_02 (36:15):
Well, right.
Yes, exactly, exactly.
These are conversations that weshould be having with our 20
somethings and 30 somethings.
Yes, yes, absolutely.
Wow.
Yeah, you know, we think ofmenopause and we think of just
um that it's a conversation forelders only.
Yeah, yeah.
Right.
(36:36):
It's down the way of the other.
Or just women today.
You know, right.
Wow.
SPEAKER_03 (36:41):
Mm-hmm.
SPEAKER_02 (36:42):
This is This has been awesome.
You know what?
One thing that I haven'tmentioned, and I should have
mentioned this up front, and Dr.
Tony, you should have mentionedthis.
Dr.
Tony is one of the founders of areally amazing organization.
Called the She's like, hmm?
SPEAKER_03 (37:02):
It's called the Oh, that little thing.
SPEAKER_02 (37:05):
Of which I am a member, but I am not the
founder.
Like one of the founders, likeshe is New Jersey Black Women
Physicians Association.
Right.
Uh NJBWPA.
Um you'll find all of uh allabout her and Dr.
Pamela Brooke online.
(37:25):
And they are a nonprofit umorganization really designed to
correct some of themismanagement and inequalities
in medical care for women andpeople with uterus and people
who love women.
Um it was formed several yearsago, and because Dr.
(37:48):
Brook is also a colleague ofmine, I was eager to join the
organization, and I'm so glad topartner with you and Black
Boomer Besties from Brooklyn totalk about these things and get
this word out across differentgenres, not just in the medical
field, not just on podcastplatforms or not just in social
(38:09):
settings, but let's just keeptalking about it and make it a
regular part of our lives.
SPEAKER_03 (38:14):
Yeah, right.
Indeed.
SPEAKER_02 (38:15):
So I really appreciate you.
I'm I I can't wait for the nextum um session.
Uh you know we keep bringinggood stuff to you.
So um if you continue to followus, you'll get all the all the
tea.
We'll spill all the tea.
All the good, good.
Absolutely.
So thank you again, dear.
(38:36):
We really appreciate it.
Thank you.
Thank you.
You two so this has been anotherepisode of Black Boomer Besties
from Brooklyn.
Brooklyn
Hey Ant.
Hey Les.
How's it going?
SPEAKER_02 (00:05):
It's going well.
Good.
We got company.
We have company.
So I'm going to be on my bestbehavior.
Actually, no, we don't havecompany today because she's
already family.
Yes, thank you.
On our podcast multiple times.
And once you get past the firstepisode of shenanigans, you're
(00:26):
in.
You're in.
So I want to say welcome toanother episode of Black Boomer
Besties from Brooklyn.
SPEAKER_03 (00:36):
Hey folks, I'm Angela, and that's Leslie, my
best friend of almost 50 years.
We are two free-thinking60-something-year-old black
women, and we've decided to bereally intentional about
inviting joy and boldness intoour lives.
We want you to come along withus.
We want you to be on your ownjourney of boldness and
(00:59):
joyfulness.
So today we have Dr.
Tony Otway back.
Do you remember her?
Yes.
She has been here before.
She is an honorary bestie.
And she's here to talk about yetanother of the myriad of aspects
(01:20):
of menopause.
She is here to talk about yetanother.
SPEAKER_02 (01:26):
So Dr.
Tony Otway, she's a licensedobstetrician and gynecologist in
New Jersey.
And we are blessed to have herhere to continue our series A
Year in Menopause.
We thought that it's importantto continue to bring this
content to you because menopausetouches everyone, whether you
(01:50):
are a female, a male, whetheryou have a uterus, whether you
know someone or love someonewith a uterus, menopause will
affect you in ways that youwould be shocked.
Hello, my dear.
unknown (02:04):
Hello.
SPEAKER_01 (02:06):
Welcome back.
Thank you.
Thank you for having me back.
I know it's been a little bit oftime, but uh yes, we're racing
to the end of the year and we'vegot some more things to talk
about with menopause.
So um let's get to it.
SPEAKER_00 (02:20):
Let's get to it.
SPEAKER_02 (02:23):
So we've talked about some of the um
cardiovascular changes um inmenopause.
And one of the things that we'vementioned that's really, really
important is how menopausetouches every aspect of our
human beings, every system,every organ.
(02:44):
And very often we don't hearabout things other than hot
flashes, perhaps.
But um, we have Dr.
Tony here to talk to us aboutother aspects of menopause.
SPEAKER_01 (02:55):
Right.
So today I want to go over bonehealth.
Um, you probably know a bit moreabout with called osteoporosis,
but they're trying to changethat name uh to encompass uh
everything that should be doneto help maintain your bones.
Um so you know, just to recapagain, menopause is uh classi
(03:17):
you're classified as menopausewhen you're one whole year
without your periods.
Average age in this country is51, and you've got to understand
that at least 40% of your lifewill be in those menopausal
years, especially because womenlive till about average age,
late 70s, 80s.
So you know, if you're becomingmenopause at 50-51, that's
(03:40):
almost 50% of your life is inthis stage.
Um so let's talk about bones.
Um let's talk about bones.
Let's talk about bones.
So you you know, you'll you seewell, you used to see a lot of
you know, you know, women who,you know, as they get older,
they start to shrink down.
And that's one of the thingsthat um when you go for your
(04:01):
yearly, um, they're doing moreand more is actually measuring
your height.
Um just to make sure that youare so if when you go for your
yearly and exams um with yourprimary care, make sure they're
measuring your height.
Uh just to see if you're losingheight at all.
So this yeah.
SPEAKER_02 (04:19):
That's funny that you mentioned that because I've
noticed that at the tender ageof 63, I've lost probably about
an inch.
Yeah.
Really, Laz?
That much?
Yeah, I don't think I'm 5'8anymore.
SPEAKER_01 (04:32):
Woo! Oh wow.
Yeah.
So um the whole thing with boneis bone is like it is a dynamic
structure.
It's constantly breaking downand building up, breaking down
and building up.
And where as where estrogencomes into this, it helps to
slow down that that breakdown.
So you continue to build, andestrogen keeps maintaining your
(04:54):
bone, uh, the strength and thestructure and the density of
your bone.
So once you lose that, um it'scontinuing to break it's it the
estrogen.
Um, once you lose the estrogen,your bone just continues to
break down faster than it'sbuilding up.
And that's where you get thisweakness in your bones, you get
loss of the density and thequality of your bones.
(05:18):
So most medications that theyput you on these days, if it's
not estrogen, it's othermedications, is to help stop
that breakdown and help tomaintain.
So just you know, go ahead.
You had a question?
SPEAKER_03 (05:30):
Yeah, I listen, uh, you it just out the gate, as we
say, out the gate, yeah.
I'm learning something because Inever think of bone as something
that is in change, in flux.
Oh, yes, constantly.
(05:52):
Constantly.
Constantly in flux.
So constantly in flux.
In incredible.
Because what that means to me isthat there is something that one
can do to affect this thingthat's constantly in flux.
We want it to flux up, not flux.
SPEAKER_01 (06:08):
Exactly, right.
SPEAKER_03 (06:10):
Exactly.
Yes.
So so wait, one other one otherthing I wanted to mention, like
um we we we so we think aboutosteoporosis and kind of maybe
like a hunching over as as oneages.
And I wanted to talk about, Iwas listening to our friend um
(06:34):
Kim Coles has this podcastcalled Reliving Single.
And they had um they had a gueston and they were talking about
menopause and aging and so on,and um how it changes the body.
And Kim mentioned that she is umdoing some hormone replacement.
(06:59):
And I've never thought aboutthat.
I've never considered it becauseI did not experience menopause
um in a in a in a disturbing wayat all.
I had hot flashes, but just likemy mother, it was very mild, um,
an annoyance, but none of thekind of horrible things that I
(07:21):
hear people experience.
And so I don't think aboutthings like um HRT, hormone
replacement theory, but when Ithink about my bones, I want to
think about HR.
Do you know what I mean?
Yes, so that was the first thingthat comes to mind is that we
have this idea that because weattach menopause to hot flashes
(07:42):
only, only and and mood, and weeven make fun of it in those
aspects, right?
We we we make fun of itourselves.
It's not only that other peoplemake fun of it and point and
direct it to us, we put levityaround it also.
Um so I never think about it,but the more that you expose me
(08:04):
and us, everyone out there, tothese the connection between
estrogen and these other systemsin our bodies, I am just blown
away.
SPEAKER_01 (08:15):
Right.
And and the the sad thing isthat um, you know, I think I'd
I'd mentioned this before thatit's it's not a subject that's
really taught in medicalschools, it's not a subject that
was really taken seriously.
Um, so with there's a wholegeneration of people when they
(08:36):
first came out with estrogenreplacement and then they scared
everybody into not taking it,there's been a whole generation
that's actually lost the benefitof using estrogen and hormone
replacement therapy because ifyou're not starting it within,
you know, the five to six, sevenyears after menopause, yeah,
it's really not a good idea tostart using it at this late
stage of the game.
(08:57):
So it really has to be somethingthat's done very close to when
you go into menopause toactually reap the benefits of
maintaining this your estrogenlevels.
That's so estrogen.
It is.
It's it is a whole generationhas been lost.
Oh my god.
Um because of the WHO study andand everything that scared
everybody.
(09:18):
So it's only these past coupleyears that we've started to push
for more um research, moreeducation, um, and pushing women
to actually try and learn andmake sure they understand what's
going on, that things havestarted to change.
Um, but again, it's a wholegeneration that's been lost to
going without estrogen.
(09:39):
Um but there are other thingsthat we can do to help uh
maintain our bones at this stageof the game.
SPEAKER_02 (09:45):
So there's a couple of things I thought of while you
were speaking, and this isreally I love the fact that
we're bringing the conversationto the public.
I met a woman, um, she wasactually my manicurist um a
couple of weeks ago, and we gotto talking.
She was a black woman who toldme that um she didn't have any
(10:08):
children.
I think she was forty-five orso, she didn't have any
children, and she said,regrettably, I went into
menopause early in my 30s.
Wow.
And she said, listen to this,she said, I found out later when
(10:28):
I could no longer have children,that my mother went into
menopause early.
And my grandmother went intomenopause early.
Oh wow.
But because we don't talk aboutthose things, her mother did not
have that conversation with herand give her the opportunity
(10:51):
perhaps to start childbearingearlier.
SPEAKER_00 (10:54):
Right.
SPEAKER_02 (10:55):
And she only found out too late.
So the fact that we're talkingabout this is just so important,
you know, to stimulate dialogueand to take the taboo off of
something that's just a naturalpart of everyone's life.
SPEAKER_00 (11:11):
Right.
Right.
Absolutely.
SPEAKER_02 (11:13):
I just I just here's here's the teacher in me and the
doctor in me also.
I just want to go back a littlebit and talk about what we call
the pathophysiology of bone lossand and getting shorter and all.
And what that means is how ithappens, what happens in order
to make these things happen.
Well, remember we talked aboutwith estrogen, it causes the
(11:35):
makeup or the matrix of thebones to get weaker.
SPEAKER_00 (11:39):
Right.
SPEAKER_02 (11:40):
And the word osteoporosis actually means
osteous bone and porosis isholes.
So it instead of the bonesforming solidly, it forms
loosely like a sponge.
Right.
So clearly the bone is not asstrong.
SPEAKER_00 (12:00):
Yeah.
SPEAKER_02 (12:00):
So if you so now you have weaker bones.
So when you fall, you're moreprone to breaks and fractures,
etc.
However, here's how you getshorter, and women and people
have that hump.
The vertebrae, the bones in theback, the spinal column, they're
obviously made of bones.
But let's say that bone getsweaker, right?
(12:22):
So they're stacked on top ofeach other.
Yep.
And the ends of the bones startlosing their density, and it
presses shorter and shorter.
And you get these small, whatthey call microfractures a
little bit.
So the end plates are likegrinding and getting shorter.
(12:43):
Instead of being nice and fulllike this, they become that's
how we lose our height.
Heights, yeah.
The bones collapse collapsedown.
Right.
And and the curves develop whenthe front, let's say, lose more
than the back.
So now it goes like this.
(13:04):
Right, exactly.
Instead of like this, you'relike this.
That's how you get these curves.
Right.
SPEAKER_03 (13:10):
Let me tell you, you went from medicine to
engineering.
SPEAKER_00 (13:16):
Now, speaking your language.
SPEAKER_02 (13:19):
So the point is, by the time you see an elderly
person who is actually stooped,we can't tell them straightened
up or whatever because they nolonger have the physical
structure and ability to standup.
Their bones no longer areperfect uh squares or
rectangles.
(13:40):
Exactly.
So as Dr.
Atwe is saying, we really needto start these restorative
processes early.
SPEAKER_01 (13:49):
Early.
Absolutely, absolutely.
And take it seriously.
Take it really seriously.
Just give you to give a fewstatistics.
Worldwide, there's about 8.9million fractures annually.
That's like somebody having a abreak every three seconds,
whether it's a hip, whether it'sin the back.
Um and uh it's it increased moreif you've had a previous
(14:11):
fracture.
Um and the hip fractures are theones that are the most and the
worst.
They cause the most problems.
There's about if you have a fithip fracture, 10 to 20 percent
of women go from being like afunctioning person in the
community to becoming having togo into a long-term uh dwelling
(14:31):
because they cannot functionanymore.
Just from a hip fracture.
Just from a hip fracture.
We're not even talking about theother ones, we're just talking
about the hip.
Why?
So it's it's a pro it's aprofound loss of function.
Yeah.
It's not just you breaking yourhip.
Like when you were younger, youcould break a hip, whatever.
But once you get older, it's aprofound loss of function.
40% of people are unable towalk, 60% need assistance within
(14:55):
the first year.
Uh, and and it's weird becausemore women are scared of breast
cancer than they are of having abone fracture.
And if you look at if if youlook at the statistics with
breast cancer, um, if you catchbest breast cancer early and it
hasn't spread and it's verylocal, um, five-year survival
rate is in is in the high 90s.
(15:17):
Um whereas the the morbidity,mortality, the death, and the um
illness from having a bonefracture is so much worse uh,
you know, than that it is forhaving breast cancer.
So we need to be more aware ofthese things, yeah.
So sit in that for a minute.
SPEAKER_02 (15:36):
Uh all this is from a lack of education.
A lack of education.
Who knew?
SPEAKER_01 (15:42):
You know, absolutely, yes, yes, yes.
SPEAKER_03 (15:45):
So you you mentioned we, you use the the word we in
describing how the things arechanging in terms of um um being
more aware and educating more.
Who is the we?
Who's taking who is leading thecharge in changing how menopause
(16:06):
is viewed in terms of someone'swhole life, not this comical um,
you know, um, we don't need tohear about that.
It's all about your mencies andthat's it.
And right, you know, um who isleading the charge?
I want to like give them flowersor something.
Well, we're talking to one ofthem.
(16:28):
Right.
I love that.
You get the flowers.
SPEAKER_01 (16:33):
You get the flowers.
And I think more and more, Iremember I said there was this
whole lost generation of womenthat are not being treated for
this.
And I think more and more ofthose lost generation physicians
are coming into this world andsaying, well, wait a minute, you
know, we need something, andthis is what's pushing um a lot
(16:54):
of, you know, more medicalschools are teaching it, there's
more research into it.
So I think it's more of thewomen that are um experiencing
this and and demanding uhanswers and demanding some help.
SPEAKER_00 (17:09):
Yeah.
SPEAKER_01 (17:10):
You know, so it's it's not impossible to slow down
the process.
And the process is notnecessarily to build your bones
back, it's to prevent preventfractures.
That's what we're trying to do,and that's the new train of
thought, is not necessarily tojust to build bones back up
again, it's to help preventfractures, preventing from uh
(17:32):
continuing to lose and make youknow by making your bones stable
so you're not losing anymore,and doing other things to help
um, you know, maintain yourheight, maintain your bones,
whether it's through diets,whether it's through exercise,
whether it's through otherthings other than estrogen.
So it's really about it's reallyabout preventing fractures.
(17:55):
And this is why they're sayingit's they're trying to move away
from that word osteoporosis tobone health, because it's it's
encompassing a lot of differentthings to try and maintain your
bones.
Wow.
SPEAKER_02 (18:08):
You know, I'll tell you, I see an integrative
medicine doctor, and I went tothem their practice because of
uh menopausal symptoms of hotflashes and all, not
necessarily, not at all relatedto bone health or whatever.
And while I've been on HRT nowfor about a year and a half, um,
(18:31):
helpful with the symptoms of umhot flashes, but on my last
visit, she sent me for a bonescan and said, it's time I want
you to get a periodic bone scanjust to check on the fitness of
your um bones and what have you.
And, you know, proverbially, Ialways in medical school, I know
(18:54):
I was taught you mo uh most ofthe population prone to
osteoporosis are the people umAsians, people from the uh
Eastern Europeans and small,frail, um blonde people um that
I never really thought thatosteoporosis was a problem in
(19:15):
our community.
SPEAKER_01 (19:17):
Right, right, right.
Because you didn't see as manyyou didn't see as many um black
women with those issues ofheight, loss of height, and the
hunching over, but you see uswith those fractures.
We do have those fractures.
Yes.
You know, we it it does it doesincapacitate us as well.
So um we are affected.
SPEAKER_03 (19:37):
I'm about to dig up my waist right now.
I'm about to start like on thiscall, I'm gonna start lifting.
Yes.
I mean, really, that's that'sthe shift.
That is what this conversationis moving me towards um taking
action because these are it whatthe what the what now?
(19:57):
One thing that I did to do,Tony, since the last time we're
here, I certainly did go out andget those Syndrome.
SPEAKER_01 (20:06):
Okay, good.
Like the next day.
Good for you, good for you.
Just a little bit, yes?
Every little bit helps.
SPEAKER_02 (20:13):
Every little bit helps, every little bit helps.
And I've started weight trainingbecause I've learned that since
June, I've heard that weighttraining, wait, wait, wait, let
me just Oh Lord, over here.
Wait, wait, yeah, no, no, no,don't I've heard that if if you
(20:34):
if you do weight training, notnecessarily to bulk up, but that
it is helpful in bone health.
SPEAKER_01 (20:41):
Absolutely.
And and please, there's amisconception that you'll bulk
up um doing weights.
We could we could never, aswomen, or we could never lift as
much weight to bulk up.
So um don't get uh, you know,don't think that.
But the the the the exercisepart of it helps to stimulate
bone formation because what itdoes is it stresses it's it's
(21:04):
almost like a mechanical stresson your bones when you're doing
weights and you're doingexercise, and that helps to
stimulate, helps to stimulatebone formation and decrease
bone.
SPEAKER_03 (21:16):
Osteoblastic.
SPEAKER_01 (21:18):
Right.
SPEAKER_03 (21:19):
I bet I bet you I'll be lifting those weights
tomorrow.
I bet you I promise you.
I feel like that's very thing inthis moment.
This is changing me.
I promise you.
SPEAKER_02 (21:32):
This is but I'll tell you, with these
conversations as with others,very often you just need to make
one or two changes.
Exactly.
SPEAKER_01 (21:42):
Yes, absolutely.
SPEAKER_02 (21:44):
I mean, in addition to bone building that weight
training does, what it also doesis it helps us with balance and
pro what they callproprioception.
Right.
And remember, when we get older,sometimes we're less steady on
our feet.
Yeah.
We uh don't see as well.
But all of that is related to anuneven muscle tone.
SPEAKER_00 (22:07):
Right.
SPEAKER_02 (22:08):
So if we continue, you know, keeping up our muscles
and our muscle strength, even ifwe do happen to have falls,
because I know I'll fall, but Iwant to be able to pick myself
up off the ground and not fallin a way where I'm breaking, you
know, these bones.
SPEAKER_01 (22:28):
Absolutely.
Absolutely.
Oh my goodness.
I know.
Okay.
So again, it's uh it's all aboutpreventing the fractures.
That's what we need to worktowards.
So um, so what do we do?
We um, you know, uh diagnosingit is based on a is a based on a
bone scan called a DEXA scan.
(22:50):
Um and what they do is theymeasure the bone density and
they compare it to a healthyyoung person.
Um and there's two two wordsthat most people probably know
there's osteopenia andosteoporosis.
So if you think of osteopenia asslightly bone slight bone loss,
(23:11):
and then osteoporosis as severebone loss.
So that's how people need to tothink of it.
So um, and usually if you'rejust in what they call slightly
bone loss, when you go throughmenopause, it'll take years
before you get to osteoporosis.
But if you're on that borderlinewhen you go into menopause, that
(23:33):
tipping you over into the severecomes very, very fast.
So again, it's something youneed to start doing from way
back when.
From way back when.
Just like everything I say.
Not June.
SPEAKER_03 (23:49):
And not June.
SPEAKER_01 (23:51):
Not too June.
Oh my goodness.
Not June.
It's all about, it's all aboutmaking sure you're doing these
things from way, way, way back.
SPEAKER_02 (24:07):
But you know, this is a concept that we talked
about in previous podcasts, andit's a common thing going around
in the medical community abouthealth 3.0.
Right.
If we want to get to a healthy70 years old, we really have to
start in our 20s.
And surprisingly, it not onlyinvolves um nutritional eating
(24:30):
and keeping your body um well,but it also involves maintaining
restorative friendships andrelationships and financial
health and wellness.
It's the combination of all ofthese things that it looks like
my video is stuck, but it's thecombination of all of these
(24:51):
things that is going to get usto a healthy 70 years old if we
pay attention to all of thesethings.
SPEAKER_03 (24:58):
Okay, but wait, hold hold on, hold on.
I get it, I get it.
Shame on me.
However, it's never too late tostart.
Thank you.
Can we get to that?
It's not too late to start.
Okay.
Listen, I'm not about to just gogo get into bed and and and stay
there.
So what what do we do at thetender age, as Leslie always
(25:22):
says, the tender age of 63.
Yes.
SPEAKER_01 (25:26):
Okay, so let's just talk about when you should
actually be tested.
You should definitely be testedwhen you're over 65.
Okay.
Uh, under 65, if you have someof the risk factors uh that
don't not include in menopause,some of the other risk factors
that I'll go over.
Um, or women that have had likefractures under 65, uh, who
smoke, who have who takesteroids, who have autoimmune
(25:50):
diseases, all these people,women that are menopausal under
65, should really have abaseline bone density scan.
SPEAKER_00 (25:56):
Okay.
SPEAKER_01 (25:57):
And they usually measure these bone densities
every two years because it itkind of takes that about that to
see any significant changes.
Oh, okay.
Um the other thing is that itused to be that you would just
take your bone density scan andthey would just read, you know,
the numbers from the bonedensity and and and treat you
(26:19):
based on that.
But there is a new, well it'snot really new, but it's
something that you should alsohave done.
It's called a frack score, andbasically it's taken into
account bone density, it's justone portion of uh measuring your
risk factor.
It's fracture risk factor, riskrisk assessment, I should say.
(26:40):
So it's a it's a frac score, andthey take into account your age,
your weight, your height,whether you use tobacco, whether
you use steroids, whether youdrink alcohol, whether you have
autoimmune diseases, rheumatoidarthritis, lupus, sickle cell.
Um, if you have family historyof people women that have
fractures early, um, and itgives you a 10-year uh risk of
(27:04):
hip and other bone fractures.
So it's not just about takingyour bone density scan anymore.
So this is something when you doa bone density, you should ask
your providers or your doctors,what is my risk?
What's my frack score?
Should I be on treatment?
Okay.
So two things you need to dofrom now.
You need to make sure you'rebeing measured when you go for
(27:26):
your primary, for your yearly,and you need to make sure you
have you get your frac score,not just the bone density
number.
It's there's a whole thing,which is again bone health.
All those things I mentioned,all bone health.
Because all those things need tobe taken into consideration to
calculate your risk.
(27:47):
Okay.
Wow.
SPEAKER_03 (27:48):
Listen, my page is almost filled here.
I'm over here taking notes.
You have no idea.
This is I tell you, this episodeis for me.
Okay.
SPEAKER_01 (27:59):
I'll share it with everybody, but I'm just so some
of the things that we that youneed to do, the easiest things.
One, it well, that the the mostthe best thing to do for when
you're going through menopauseis always hormone replacement
therapy, estrogen.
But again, this needs to bestarted sooner rather than later
when you first getting intomenopause.
(28:21):
Even if you're starting to seeirregular periods, it's best
time to start anything if you'regonna usually once you're five,
six, seven years out, it's notum you there's other issues that
may be going on, cardiovascularproblems, if you're diabetic,
all these other things thatcould come into play.
Um, so estrogen is always thenumber one.
In terms of diet, you shouldneed to make sure you're taking
(28:42):
enough calcium in every day, atleast 1200 milligrams per day.
Um, and there's two forms ofcalcium: there's calcium
carbonate, which should be takenwith food such as which is like
tums, and then there's calciumcitrate or citrical.
And most of these are over thecounter.
So it's 1200 milligrams ofcalcium per day.
You're getting that answer.
(29:02):
I don't have my pen handy.
Oh, I got it.
Oh, I got it.
Vitamin D, you need to begetting four to eight hundred
international units per day tohelp prevent uh, you know, falls
and uh sorry, uh help to preventfractures.
Um and this needs to be divideduh to increase your absorption.
Because if you take too much, ita lot has to do with your GI,
(29:25):
um, what's going on with yourstomach.
So um sometimes it's a littlebit more harder to absorb that.
So you know where we get ourvitamin D from?
The sun.
The sun.
But the sun may not always begood for us either.
Um and I'm gonna talk about ourskin in a little while.
So um things that um haveincreased vitamins in, you know,
(29:45):
we have fortified uh milk andcereal, all these things have
added um vitamin D in.
Um, and just have a healthydiet, egg yolks, liver.
I don't know if anybody likesliver, but whatever.
Um So uh so all these thingsthat have extra vitamin D that
they have put into our foods.
(30:06):
Um but if we have uh if wecontinue the way we're going,
who knows what our foods aregonna be like in the future.
I don't know.
Yeah.
Maybe I'll follow you where yougo.
Um so other things that we needto do, which we talked about was
r uh regular weight, um weighttraining, muscle strength, even
(30:27):
if it's just walking, uhtreadmill, uh, you know, you get
on your peloton, those these areall the things that help with
muscle strength.
And again, it's it's a stressor.
So it's helping to build thatmuscle or those bones up.
Um again, quit smoking if you'resmoking and moderate and try and
decrease your alcohol intake.
(30:48):
So um these are some of thethings you can do to uh just on
a day-to-day basis.
Um and then there's also themedications that you can take.
You hear about and all thesemedications work the same way as
estrogen, which is to helpdecrease um the reabsorption of
the bone.
It's called reabsorption.
(31:10):
Um things like your phosmax,your actinel, your prolia.
Prolia is an injection, allthose other ones are um
medications you take by mouth.
Um so there are other things,you know, there are pills that
you can do if you're not takinguh hormone replacement therapy.
SPEAKER_02 (31:29):
So the main thing is to get it checked.
Get it checked first,absolutely.
Start the process as early aspossible so you know what your
numbers are and your riskfactors.
Right.
I love that.
So, Dr.
Tony, in the in the we have justuh not too too much longer.
Um t tell me, does the menopauseaffect loss of estrogen affect
(31:53):
the skin?
SPEAKER_01 (31:54):
Oh, absolutely, your skin and hair.
But let me just say somethingreally quickly about the bone
still.
Um, if anybody's had bariatricsurgery, um that also will
increase your bone loss becauseyou're not absorbing your
calcium, your vitamin D.
So you've got to make sureyou're on top of that too.
Okay.
Good point.
Good point.
Skin, estrogen helps tostimulate the collagen in your
(32:15):
skin, which keeps it elastic andstops that whole droopiness and
those wrinkles.
It keeps that elasticity.
Yeah, I have oh yeah, like this.
Sometimes do you ever stand inthe door like this?
And you're like, yes.
SPEAKER_02 (32:29):
I'm like, wait, wait, all I need is a piece of
tape.
SPEAKER_03 (32:37):
I'm like, what fingers?
Yeah, I don't see any fingers.
SPEAKER_01 (32:41):
I stand there sometimes, and I'm like, geez,
when I was like when I was 20,this used to be all the way up
like so good.
Oh Lord.
So collagen, okay collagen,hyaluronic acid.
It's another one stimulateshyaluronic acid.
(33:02):
And hyaluronic acid helps tokeep the skin um moist,
maintains the moisture in yourskin.
So you see all thesemedications, um, you know, all
these hyaluronic acids that youcan put on.
I use them.
Um all this kind of stuff,right?
So estrogen also decreasesinflammation, which causes, you
(33:24):
know, bruising or wrinkling andit helps with wound healing and
prevents antioxidant damage fromthe sun.
So you have to be very careful.
So even though you need the sun,you have to be careful with the
sun.
Just because we're black people,too, you need to make sure
you're still protecting yourselffrom the sun.
Yes, uh, making sure you usesunscreen.
Okay.
(33:45):
So you should really usesunscreen, uh, especially
though, those people in thesouth, you need to be using the
sunscreen.
So and then it also with thehair, it stimulates the hair
follicles and maintains it keepsyour hair in that state of
growth.
Always, it's always growing,you're losing it, growing.
Once you lose that estrogen,that growth phase just like
(34:06):
drops off.
That's when you'll see thethinness, thinning, um, the
brittleness.
Yes, that's what estrogen doesfor you.
So estrogen is like this thismagic pill.
It's a magic, magic, magicbullet.
Absolutely.
Absolutely.
So, yeah, those are the things.
And those uh estrogen is great,but you know, like I said, that
(34:30):
we've lost a lot.
So um, but another thing I alsowanted to make sure I talk about
with um with the bone loss, itto help with um not getting a
fracture is making sure thingslike getting your eyes tested,
making sure you don't haveobstacles in your house, make
sure you don't have rugs thatdon't, you know, that that have
a backing on that won't slip.
SPEAKER_03 (34:52):
Yeah.
SPEAKER_01 (34:52):
Making sure you in the wintertime you're clearing
off that black ice, you're notwalking out there blindly.
SPEAKER_02 (34:58):
Do you know what the number one of the number one
reasons I have patients comeinto the aura for fractures?
SPEAKER_00 (35:06):
Walking their dogs.
SPEAKER_02 (35:07):
Their dogs on the right walking, the elders walk
their dogs, and the dogs gettangled, the little dogs get
tangled in their legs.
Right.
How many times has Simba trippedme up getting in between my
legs?
Yes.
Yeah, so people have to be verycareful about that.
You be careful about how oftenthat happens.
SPEAKER_03 (35:26):
The world is dangerous out there.
SPEAKER_02 (35:31):
And not even just we need to just sit on our couch
with the weights.
Oh gosh.
Oh my goodness.
Yeah.
That is.
Yeah, absolutely.
Absolutely.
You know, going to the days, Ireally felt badly for the lady
(35:54):
that said her mother just nevertold her something.
So, you know, that was agenerational issue for her.
SPEAKER_00 (35:59):
Yeah.
SPEAKER_02 (36:00):
And she really had a lot of resentment and uh over
the loss of the ability, youknow.
She said had she known, shewould have had children when she
was much younger.
SPEAKER_03 (36:10):
Right.
Well, her mother didn't knoweither.
That's why this conversation hasto be intergenerational.
SPEAKER_02 (36:15):
Well, right.
Yes, exactly, exactly.
These are conversations that weshould be having with our 20
somethings and 30 somethings.
Yes, yes, absolutely.
Wow.
Yeah, you know, we think ofmenopause and we think of just
um that it's a conversation forelders only.
Yeah, yeah.
Right.
(36:36):
It's down the way of the other.
Or just women today.
You know, right.
Wow.
SPEAKER_03 (36:41):
Mm-hmm.
SPEAKER_02 (36:42):
This is This has been awesome.
You know what?
One thing that I haven'tmentioned, and I should have
mentioned this up front, and Dr.
Tony, you should have mentionedthis.
Dr.
Tony is one of the founders of areally amazing organization.
Called the She's like, hmm?
SPEAKER_03 (37:02):
It's called the Oh, that little thing.
SPEAKER_02 (37:05):
Of which I am a member, but I am not the
founder.
Like one of the founders, likeshe is New Jersey Black Women
Physicians Association.
Right.
Uh NJBWPA.
Um you'll find all of uh allabout her and Dr.
Pamela Brooke online.
(37:25):
And they are a nonprofit umorganization really designed to
correct some of themismanagement and inequalities
in medical care for women andpeople with uterus and people
who love women.
Um it was formed several yearsago, and because Dr.
(37:48):
Brook is also a colleague ofmine, I was eager to join the
organization, and I'm so glad topartner with you and Black
Boomer Besties from Brooklyn totalk about these things and get
this word out across differentgenres, not just in the medical
field, not just on podcastplatforms or not just in social
(38:09):
settings, but let's just keeptalking about it and make it a
regular part of our lives.
SPEAKER_03 (38:14):
Yeah, right.
Indeed.
SPEAKER_02 (38:15):
So I really appreciate you.
I'm I I can't wait for the nextum um session.
Uh you know we keep bringinggood stuff to you.
So um if you continue to followus, you'll get all the all the
tea.
We'll spill all the tea.
All the good, good.
Absolutely.
So thank you again, dear.
(38:36):
We really appreciate it.
Thank you.
Thank you.
You two so this has been anotherepisode of Black Boomer Besties
from Brooklyn.
Brooklyn
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