International Women's Day: Defeatist myths about osteoporosis have helped perpetuate one of the biggest public health crises facing women in West – Dr Lynne Wigens

International Women’s Day is a time to celebrate the empowerment of the world’s 3.9 billion women.

Safe and effective treatments can help maintain a healthy skeleton (Picture: John MacDougall/AFP via Getty Images)
Safe and effective treatments can help maintain a healthy skeleton (Picture: John MacDougall/AFP via Getty Images)

It’s also a day to call out the barriers holding them back. One such burning injustice is the defeatism that’s characterised the fight against osteoporosis, one of the most urgent threats to living well in later life.

While the disease can affect anyone, its impact on post-menopausal women is widespread, predictable and devastating: no fewer than half of women over 50 will suffer fractures due to osteoporosis, making it one of the biggest public health crises facing women in the western world.

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Despite the costs to society, efforts to beat this disease have been set back by its low profile. In the UK, even before Covid, the treatment gap was startlingly wide, with two-thirds of women missing out on necessary care.

Fracture liaison services (FLS) are the world-standard for getting people onto treatment, but a postcode lottery means that 90,000 people every year are slipping through the cracks. These inequalities run deep across Scotland, as well as England, despite Glasgow being the birthplace of FLS.

Safe, effective, bone-sparing medication can help people live well, but variations in local services are fuelling life-changing and preventable spinal and hip fractures.

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These broken bones aren’t just painful setbacks; as many people die of fracture-related causes as from diabetes or lung cancer. With a fifth of women with osteoporosis suffering three or more broken bones before they’re finally scanned and diagnosed, what we’re tolerating is the gradual chipping away of the independence of hundreds of thousands of people.

Astonishingly, 70 per cent of ‘red flag’ spinal fractures never come to medical attention, leaving 180,000 Scots at heightened risk of suffering a hip fracture. And with hip fractures alone forecast to take up 52,000 acute hospital bed days in Scotland over the next five years, it’s no wonder the NHS is finding it difficult to keep up with demand, with long waiting lists.

How come this serious crisis has grown so insidiously, under the radar, for so long? Part of the problem has been dangerous stereotypes and about ageing and bone health.

Four in ten people think breaking bones, losing height and being hunched over are just normal parts of getting older, rather than alarm bells for a highly treatable condition.

The Holyrood and Westminster parliaments are starting to become more aware, but previously weren’t immune to this normalisation of disease, despite spiralling costs of £4.6bn a year to taxpayers.

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It's high time to take on the fatalism and tackle bone health and osteoporosis. Our later years should be about fun, fitness, freedom and family; not fractures, falls and hospital wards.

I worked as an NHS nurse for many years. I’ve seen first-hand how important it is to encourage bone health, so people get calcium and vitamin D while doing weight-bearing exercise. Prevention needs to be more than just a buzzword. We need to identify and treat osteoporosis before a person becomes debilitated.

On International Women’s Day, let’s not miss this opportunity to shake ourselves out of our complacency and have challenging conversations about subjects once left unspoken.

We need to change the culture around this condition from passivity and fatalism to one of optimism and determination.

Dr Lynne Wigens is a trustee of the Royal Osteoporosis Society

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