WORDS BY CATHERINE ETTY-LEAL AND DR KATHY YU
While we’ll often speak to the ‘mind’ and ‘body’ as separate and distinct, we know our mental and physical health is interlinked and interwoven. Poor physical health can increase our risk of developing mental health problems, and similarly, poor mental health can negatively impact our physical health.
Arts Wellbeing Collective member organisation, Performance Medicine, are well-versed on the impact that the performing arts can have on our bodies. Here, they offer insight into the impact of our ever-changing hormones on our vital bone health.
Bone health is important for everyone. From a young age we build the foundations of what our bone health will be like later in our lives. Preventing diseases like osteoporosis is a key part of bone health in our early years.
Weight bearing exercise and adequate nutrients are important factors that help increase the strength of our bone. However, there are things that can impede our ability to build and maintain healthy bones.
Low bone density can put you at risk of stress fractures when you are young and exercising.
Reduced vitamin D and low calcium levels are the better known factors, but did you know that hormones can affect your bone health, too?
Everybody releases hormones in varying levels at various times over their lifespan. At puberty, the sexual organs develop rapidly in preparation for reproduction. In doing so, the sex hormones like oestrogen, progesterone and testosterone tend to increase their secretion in the body and then stabilise themselves for most of adult life. The ovaries are responsible for regulating the release of oestrogen and progesterone, and the testes are responsible for testosterone. It is these hormones that can have the biggest impact on the health of our bones.
Hormonal changes throughout our life affect our body’s ability to strengthen bones.
For example, if there is a late start to puberty, bone density may be lower due to the delayed release of oestrogen. In a similar way, pregnancy can create a change in hormonal cycles, which can be linked to transient osteopaenia (low bone density during pregnancy). This can also happen while breastfeeding, as breastfeeding suppresses the release of oestrogen. Menopause brings about another hormonal fluctuation which can increase the risk of osteoporosis developing.
People who do not experience periods generally have a lower rate of osteoporosis as they do not go through menopause, and release different hormonal levels more consistently. In those taking testosterone, there has been no evidence to suggest a detrimental effect on bone mineral density.
But what about if you have had surgery to your ovaries, or have been taking hormone therapy medication? In research studies that have explored the effect of hormone therapy on bone health, researchers found that oestrogen therapy actually protects bones from becoming weaker.
Researchers have also concluded that following surgical removal of the testes, there is no significant effect on bone health, whether oestrogen therapy is taken following this surgery or not. However, should an oophorectomy (surgical removal of the ovaries) be performed prior to the age of 45 and no hormone replacement therapy given, the risk of osteoporosis may increase.
Regardless of your gender identity or age, we should all do what we can to maintain healthy and happy bones. Eat plenty of calcium, exercise, get enough sunlight (with sunscreen and hats depending on the season) and stay strong! If you aren’t sure if your hormones are doing what they should for your bones, chat to your doctor.
Dr Kathy Yu is a Sports Doctor who provides complex and comprehensive musculoskeletal management for many professional performing arts workers.
Catherine Etty-Leal is a physiotherapist with an interest in dance, performance, vocal, TMJ, musculoskeletal and sports physiotherapy.
For more information, visit performancemedicine.com.au
This article appeared in Spotlight, the Arts Wellbeing Collective magazine: