Standing Tall
Two important steps to maintain height in older years
Dr. Howard Lewine
Harvard Health Publishing
Starting at about age 40, people typically lose about half an inch each decade. And the decline usually speeds up after the 70th birthday.
Two of the most common causes are osteoporosis and bad posture.
Signs of osteoporosis
As we get older, our bones become less dense and more brittle, and they are more likely to fracture. This loss of bone tissue is called osteoporosis.
When a hip or wrist bone weakened by osteoporosis breaks, it’s usually the kind of crack we have in mind when we picture a broken bone. But fractures of the bones that make up our spine, called vertebrae, are different. Thin vertebrae get easily crushed. It’s like a cardboard box that has had too much weight put on it.
Most compression fractures happen without any known trauma or injury. And usually there are no symptoms. Sometimes there can be a more sudden vertebral collapse, which can be very painful. All types of vertebral compression fractures result in loss of height.
You can decrease the risk of losing more height the same way you prevent or treat osteoporosis. Eat a calcium-rich diet. Be sure you get enough vitamin D, such as taking a 1,000IU vitamin D supplement daily.
Healthy bones require daily exercise, such as walking and/or weight training. Putting “pressure” stimulates new bone growth and prevents bone loss.
If you haven’t had a bone density test, you should get one. It’s an easy test to see if you need treatment for thin bones.
Posture pointers
Bad posture may be even more of a factor in height loss associated with age. Some of us had a tendency to slouch in our teens that never quite went away. And if you spend a lot of time in front of a computer, you might notice how your back bends toward the video monitor and your shoulders roll forward.
Weak back and abdominal muscles also contribute to poor posture. Two simple exercises that can strengthen these weak muscles and help you stand straighter are the Superman and plank poses.
To do the Superman, lie face down with your arms extended overhead. Lift your legs, shoulders and arms off the floor simultaneously and hold for two to three seconds. Rest and repeat the lift about five times.
For the plank, lie face-down with your forearms on the floor, legs extended and feet together. Push into your forearms as you raise your body so it forms a straight line from your head and neck to your feet. Keep your gaze down and engage your abdominal muscles. Hold for up to 30 seconds and then lower your body. Rest and repeat three times.
Dr. Howard LeWine is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health. harvard.edu.
US regulators to examine testosterone for women
Siddhi Mahatole and Padamanabhan Anathan
Reuters
U.S. health regulators planned to review the scientific evidence on testosterone use in menopausal women on Thursday, including its benefits, risks, dosing and role in female health, as well as perspectives from doctors and patients.
The public meeting, which the U.S. Food and Drug Administration said could help guide future research and drug development, comes as a growing number of women are turning to testosterone to manage menopause symptoms.
There is no FDA-approved testosterone therapy for women, despite years of off-label use to treat low sexual desire, known as hypoactive sexual desire disorder, or HSDD.
Last year, the FDA removed the boxed warning about increased cardiovascular risk from testosterone products for men after reviewing post-marketing studies, though the products still carry warnings about increased blood pressure.
Physicians who prescribe testosterone to women typically rely on low doses of products approved for men, often dividing existing products such as AbbVie’s ABBV.N AndroGel and Keenova Therapeutics’ Testim, or on compounded formulations.
The lack of a female-specific product creates practical challenges for clinicians, said Dr. Diana Tordoff, an instructor in obstetrics and gynecology at Stanford, noting that an approved product could provide standardized dosing, labeling and safety-monitoring guidance and potentially improve insurance coverage.
Still, some experts say key questions remain unresolved. More long-term safety data are needed, said Dr. Stephanie Faubion, director of Mayo Clinic’s Center for Women’s Health.
The United Kingdom, Australia, New Zealand and South Africa have approved or licensed testosterone products specifically for women.
The FDA’s request for public comments ahead of the meeting attracted hundreds of submissions, many from women describing improved libido, energy and quality of life while using testosterone.
Interest in testosterone among menopausal women has grown alongside claims on social media that it can improve energy, muscle mass, bone health and cognition, though specialists say the evidence is strongest for HSDD.
“We do not have any evidence in women that it will improve muscle mass or bone density or mood or well-being or really any other metric,” Faubion said.
Dr. Karen Adams, director of Stanford Medicine’s Program in Menopause and Healthy Aging, said testosterone has been reviewed by the FDA four times for use in women but has never been approved because of a lack of long-term safety data and concerns about cardiovascular and breast cancer risks.
The FDA has approved non-testosterone options like Sprout Pharmaceuticals’ Addyi and Cosette Pharmaceuticals’ Vyleesi for certain patients with HSDD.
Testosterone is generally not recommended for women with a history of breast cancer because it can be converted to estrogen in the body that can drive some cancers.
Excessive testosterone exposure can cause acne and increased hair growth, physicians said, while rarer effects such as voice deepening and hair loss may be irreversible.
Studies show that testosterone therapy is generally considered safe for men with medically diagnosed low levels of the hormone when prescribed and monitored by a doctor.
Tordoff and Adams are leading Stanford’s MIX-T pilot study examining how low-dose testosterone affects vaginal health and the vaginal microbiome in postmenopausal women. Results are expected within the next two years.
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