Meghan Rattigan, D.O., on Preventing Osteoporosis

Meghan I. Rattigan, D.O., FACOG, MSCP

Credit: Hackensack Meridian Health

Osteoporosis affects millions of women worldwide, yet many don’t realize they’re at risk until it’s too late. In honor of World Osteoporosis Day, The Educated Patient spoke with Meghan I. Rattigan, D.O., FACOG, MSCP, an OB-GYN at Jersey Shore University Medical Center at Hackensack Meridian Health, about why osteoporosis is known as the “silent disease,” how menopause accelerates bone loss, and the simple lifestyle steps every woman can take to protect her bone health at every stage of life.

Why is osteoporosis often called a “silent disease,” and when should women start thinking about their bone health?

Meghan I. Rattigan, D.O.: That’s a very good question. Osteoporosis is often called a silent disease because it usually develops with very few symptoms until it’s already progressed. Unlike arthritis, for example, osteoporosis doesn’t typically cause pain. Most people feel completely fine and go about their normal activities until a fracture occurs — and by that point, bone mass has already significantly decreased.

As for when to start thinking about bone health, the earlier the better. Prevention is always easier than treatment. If I had to pick a specific age, I’d say by your mid-30s, since that’s when women reach their peak bone mass. After that, bone density begins to decline — about 2% each year.

How does menopause affect bone density, and why does the risk for osteoporosis increase at this stage?

MR: During menopause, fluctuating and declining estrogen levels disrupt the body’s natural balance of bone remodeling. Normally, bone is constantly breaking down and being rebuilt, but when estrogen decreases, the breakdown process outpaces rebuilding. This leads to a faster rate of bone loss during and after menopause.

What are some early warning signs or risk factors women should pay attention to?

MR: Because osteoporosis is so silent, early warning signs are subtle. Losing height, developing a hunched posture, or noticing receding gums can be early clues. Weak grip strength can also be an indicator.

If a person experiences a fracture after a minor fall or bump, that’s called a “fragility fracture” — and it’s often the first sign of osteoporosis.

Risk factors include endocrine disorders like thyroid disease or diabetes, parathyroid issues and low body mass index. Certain medications — such as steroids, antidepressants and aromatase inhibitors used in breast cancer — can increase risk. Smoking, excessive alcohol use and a family history of early fractures are also important risk factors.

Are there specific vitamins or nutrients that support bone health during and after menopause?

MR: Yes, absolutely. We always encourage getting most vitamins and nutrients from a well-balanced diet, but two key supplements stand out for bone health: calcium and vitamin D.

For women over 50, I recommend 1,200 milligrams of calcium and 1,000 IU of vitamin D daily. But don’t overdo it — too much of either can be harmful. Supplement only as needed and get the rest from food sources.

How much of a difference can lifestyle choices make in preventing bone loss?

MR: A huge difference — more than most people realize. Limiting alcohol to fewer than three drinks a day and quitting smoking completely can significantly lower risk. Exercise is also crucial, but the type matters.

Weight-bearing and strength-training exercises — like walking, jogging, dancing and light weightlifting — help build stronger bones. Even starting with 1- to 3-pound hand weights or using a weighted vest can make an impact. When combined with good nutrition, adequate vitamin D and calcium, and healthy habits, these changes can reduce osteoporosis and fracture risk by 30% to 40%.

Finally, what’s one message you’d like women to remember on World Osteoporosis Day?

MR: Start now. Don’t wait until there’s a problem. Build healthy habits early — cut back on alcohol and smoking, get your nutrients and make strength training a regular part of your routine. Protecting your bone health today sets you up for a stronger, more active future.

This transcript was edited for clarity.