How Penn Medicine Is Improving Women's Bone Health

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Many women don’t realize they have osteoporosis until they experience a fracture. See how we can help keep your bones healthy.

Osteoporosis — meaning “porous bone” — is a silent disease, so it doesn’t cause any obvious symptoms.

It occurs when your body doesn’t make enough bone tissue, has lost too much bone tissue, or both. Bones become weak, and they can break from a fall or, in serious cases, even a sneeze.

How Osteoporosis Affects Your Body

Healthy bones look like honeycombs under a microscope. But when you have osteoporosis, these holes and spaces are much larger than they should be. This is because they’ve lost density or they have abnormal tissue structure.

Mona Al Mukaddam, MD, MS, Director of the Penn Bone Center and Assistant Professor of Clinical Medicine and Orthopaedic Surgery, says that it’s imperative women start screening and treatment early before a fracture occurs.

Here’s how Penn Medicine’s Bone Center can help keep your bones healthy.

The Importance of Screening for Osteoporosis

Many patients first realize they have osteoporosis when they break a bone or notice other changes in the shapes of their bones, like a curved spine. By that time, you may have already lost 20 percent or more of your bone mass. With more innovative screening, you can find out if you have signs of osteoporosis earlier, in order to begin treatment sooner.

Currently, dual energy X-ray absorptiometry (DXA) scans — which measure bone density (the amount of bone mineral in your bone tissue) — are used to screen patients for osteoporosis. This is a simple, painless exam that takes 5 to 10 minutes and uses very little radiation. You’re actually exposed to 10 to 15 times more radiation in a flight from New York to San Francisco.

Sometimes, though, fractures are more than just a result of bone density loss.

The Penn Bone Center uses tools to provide more information about your bone quality that a DXA can’t provide, such as:

  • Trabecular Bone Score: A technique that analyzes the spine images acquired with a DXA scan and provides information regarding bone texture and has been shown to provide a better ability to predict the risk of fractures, trabecular bone score evaluations are noninvasive and are acquired on all patients seen at the Penn Bone Center at the same time as the DXA scan with no additional exposure.
  • Bone Biopsies: These are only performed at specialized medical centers in the US. A bone biopsy is required in only a subset of patients and involves a small cut to remove a sample of your iliac crest (pelvic) bone. The sample is used to learn more about the cause of poor bone quality and guides treatment in more complicated osteoporosis cases.

Bone Health Starts With You

Bone health is more than just screening — it’s making choices in your everyday life that benefit your bones. The strength of your bones depends greatly on maintaining a healthy diet and getting exercise.

Calcium and Vitamin D

These keep your bones strong and prevent them from losing density over time.


  • Dosage for women between 19 to 50 years old: 1,000 milligrams (mg) of calcium daily.
  • Dosage for women older than 50: 1,200 mg of calcium daily.
  • Sources: Dairy foods, almond milk and orange juice fortified with calcium, canned sardines, salmon with bones, and green leafy vegetables.


  • Dosage for women between 19 and 70 years old: Minimum of 600 IU (international units) of vitamin D daily.
  • Dosage for women older than 70: Minimum of 800 IU of vitamin D daily.
  • Sources: Tuna, cheese and egg yolks.

Things to Avoid

  • Smoking
  • Excessive alcohol
  • Excessive caffeine
  • Exercise
  • Exercise is just as important for your bones.
  • Mix aerobic activity with light weight-bearing or resistance training.
  • Integrate exercises that can help improve balance and decrease the risk of falls.
  • Aim to exercise at least 150 minutes weekly.

Earlier Diagnosis, Earlier Treatment

Osteoporosis requires an integrated approach. There’s no one treatment that cures it, but there are many ways to build your bone health and lower your risk of fractures. Treatment may include:

  • Increasing your calcium intake through calcium-rich foods, such as yogurt or almonds, and taking supplements
  • Exercising in ways that help keep your bones strong, such as weight-bearing exercises and yoga
  • Fall-proofing your home, such as installing handles in the shower or near steps
  • Avoiding activities and substances that hurt your bones, such as smoking and excess alcohol
  • Taking prescribed medications that can improve your bone health

The Penn Bone Center is specifically designed for bone health. Dr. Al Mukaddam says, “We have a specialized team of experts who can help our female patients with osteoporosis. These specialists know the ins and outs of osteoporosis treatment — specifically when it comes to women — and the team is committed to keeping your bones healthy.”

Though osteoporosis is one of the most common bone diseases, Penn’s specialists assess and treat women with varying kinds of bone concerns, such as patients with Paget’s disease, parathyroid disorders, and other conditions that cause abnormal bone repair and growth.

“We work very closely with all of our specialists to personalize our patient’s care and tailor it to their specific needs,” Dr. Al Mukaddam says. A patient’s treatment depends on many factors, such as medical history, age, and results from any screenings that are performed.

Why Your Bone Health Matters

Fractures from osteoporosis are very common — but they don’t have to be. Screening for osteoporosis is crucial, as there are interventions that can effectively decrease your risk for a fracture.

“Fractures can cause significant pain and have tremendous negative effects on a women’s quality of life and independence,” Dr. Al Mukaddam says. “By maintaining your bone health on your own and taking advantage of screening and treatment at the Penn Bone Center, you’re one step closer to ensuring you can live a happier, bone-healthy life.”

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