3 Syndromes to Take Seriously

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The names may sound off, but these potentially serious syndromes are very real. Here's what you should know.

Frozen Shoulder

What it is: A condition that occurs when the shoulder capsule (tissue around the joint) thickens, causing pain and limiting motion. It can worsen over weeks or months. Frozen shoulder is twice as common in women as in men and typically crops up between ages 40 and 65.
What causes it: Usually nothing in particular— it often happens out of the blue, says Stephania Bell, PT , an orthopedic clinical specialist and member of the American Physical Therapy Association. But it can be linked to diabetes, thyroid disease or a previous shoulder injury.
What helps: Physical therapy and exercises that stretch and strengthen your shoulder. Most people see significant improvement within one year, says Bell. You can find a physical therapist in your area at moveforwardpt.com.

Restless Legs Syndrome (RLS )

What it is: A neurological disorder that causes an uncontrollable urge to move your legs constantly, typically when you're resting. It's twice as common in women—and often occurs during pregnancy— but 10 percent of adults probably have it to some degree, says Mark Buchfuhrer, MD, a member of the advisory board at the RLS Foundation.
What causes it: No one knows for sure, but it may be due to a brain chemical (dopamine) imbalance or an iron deficiency. There's also a genetic component, as it tends to run in families.
What helps: A quick fix is to walk a lap around your house. Regularly exercising or upping your iron intake (discuss this with your doc first) can also help. For about 2 percent of the population, RLS seriously affects quality of life and requires prescription drug treatment.

Dry Mouth

What it is: Pretty much what it sounds like: Your mouth becomes very dry, almost as if you're chewing on cotton.
What causes it: A lack of saliva, which can be caused by an autoimmune disease, combining medications (such as antihistamines and antidepressants, which can affect your salivary glands) or simple dehydration, says Wanda Gonsalves, MD, associate professor at the Medical University of South Carolina, Charleston. Dry mouth contributes to gum disease and cavities because saliva has plaque-fighting properties.
What helps: Try drinking more water, chewing sugar-free gum or sucking on sugar-free hard candies to stimulate saliva production. If that doesn't help after a few days, talk to your doctor. He may suggest switching your medications or screen you for an autoimmune disease.

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10 Common Foot Conditions Explained

They keep us grounded, get us where we need to go and bear the brunt of exercise, but instead of treating our tootsies with the attention they deserve, we often sacrifice the health of our feet for fashion. Those super-high stilettos may look sexy, but the price of wearing them isn't pretty. Heels aren't the only foot faux pas; flats can be just as damaging. Here, advice from the pros on how to stay one step ahead of the most common foot problems.

Toenail Fungus
If you notice your toenail looks yellow, has white marks on it or contains debris underneath, chances are a fungus is hanging out under your nail. "It's a highly contagious infection that's transmitted from foot to foot, particularly in germy hotbeds like nail salons and gyms," says Carolyn McAloon, DPM, spokeswoman for the American Podiatric Medical Association. Usually it's not painful, although wearing a shoe that's pressing on the infected area can irritate it, she says. Fungi thrive in dark, wet, warm areas. To prevent one from taking hold, wear shoes made of breathable fabrics, like leather or canvas, and be sure to take off your socks and shoes to air out your feet after exercising or working all day. A fungus can be treated by trimming and filing any loose areas of the nail, soaking feet in water that contains a few drops of tea tree oil (which is a natural antifungal), using a topical antifungal treatment (if necessary) and bleaching the shower to kill any lingering fungus, says Dr. McAloon.

Heel Pain
The biggest culprit for heel pain, or plantar fasciitis, is wearing the wrong shoes for the activity you're doing. For example, if you don ballet flats for taking a daylong sightseeing stroll, your heels won't get the support they need, says Dr. McAloon. "Improper shoes are like dessert: If you wear them in excess, there are likely to be negative consequences," she adds. Be smart about your shoes. If you have to wear heels to a meeting, bring a pair of sneakers for the commute. Stretching and icing your heels can help relieve pain. From a seated position, try flexing your feet by pulling your toes toward your nose. Rolling your feet over a frozen water bottle can also alleviate discomfort. 
Burning
Have you ever taken off your heels after dancing the night away and been overcome with what can only be described as an inferno under your feet? If so, you can thank your shoes. "When you squeeze your toes into narrow high heels, you put pressure on the balls and sides of the feet, so the nerves between your toes get compressed, causing a burning, tingling or numbness between the toes and in the ball of the foot," says Amber M. Shane, DPM, FACFAS, a reconstructive foot and ankle surgeon in Orlando, Florida. Shoes need to accommodate the foot so there's room for toes to wiggle. The ideal heel height is less than two inches. However, since most women won't go that low, a platform heel is a good compromise. This stacked heel makes full contact with the ground, which distributes pressure more evenly, says Dr. Shane.

Bunions
If you've seen someone with a bump on the side of her big toe, it's not an extra knuckle—it's a bunion. These unsightly bulges appear thanks to an inherited foot type, which deforms the bones and ligaments, says Dr. McAloon. Wearing shoes that crowd the toes or are too tight can increase the likelihood of getting them and make existing bunions worse. To prevent a bunion from appearing in the first place, stick to shoes with a roomy toe area. If you do have a bunion, a gel pad can help minimize contact with the shoe, Dr. McAloon says. If your bunion becomes inflamed and painful, apply ice packs several times a day to reduce swelling. The only way to actually get rid of a bunion is through surgery, so if pain interferes with daily activity, talk to your doctor, recommends Dr. McAloon.

Toe Cramps
Unlike other parts of the body, toes just aren't that flexible, so when they end up in a position they aren't used to, the muscle becomes strained and cramps. Anything from new shoes, exercising or dehydration can cause a toe cramp. To ward them off, break in new shoes before extended wear, go easy on your feet if you're partaking in a new exercise class and make sure you're drinking enough water, says Dr. Shane. At the onset of a cramp, stop what you're doing, take off the shoe and stretch the toes back and forth. If you continue to move through the cramp, you can end up tearing the muscle, she says. 

Corns or Calluses
When the skin on your feet continuously rubs against your shoes or against itself, the result can be a corn or callus. Both consist of hard, dead, thick skin. Corns usually appear on or between the toes, while calluses form on the soles of the feet or the side of the big toe, explains Dr. McAloon. Use a pumice stone to buff rough skin, or try a urea cream, which can slough it away. To prevent both conditions, your first line of defense is to make sure your shoes fit properly. Feet can change and swell due to pregnancyand other health conditions, so you should get them measured every few years by a shoe store employee. The best time to get your feet measured is in the late afternoon and, since most feet aren't the same size, always buy the larger foot's size. It's also a good idea to opt for closed-toe shoes, since feet move around more in sandals. To reduce the friction caused by ill-fitting shoes, place moleskin or padding on the affected areas. If pain occurs, particularly from a corn, see your doctor, who can remove it.

Achilles Tendonitis
You may not be the heel-wearing type, but even some flats can be, well, too flat. When your feet are close to the ground and your heel isn't supported properly, you can pull the tendon that attaches the heel to the foot, says Dr. McAloon. Flip-flops, flats or any shoe that bends, folds or twists at the center shouldn't be worn for prolonged periods of time, she says. The painful condition will improve with rest, and ice can help ease pain and inflammation.

Bone Spur
Wearing a rigid shoe can cause your Achilles tendon to rub against the fabric, which can form a bump. Basically it's calcification that appears where the tendon attaches to the heel bone, says Dr. Shane. It can result from exercise, wearing new shoes or weight gain—anything that puts stress on the area. At the onset of pain, stretch the backs of your feet. Anti-inflammatory meds, like ibuprofen, can reduce inflammation and swelling, Dr. Shane says.

Ingrown Toenail
"Contrary to popular belief, it's not the nail that's growing into the skin, but the skin that's growing up over the nail," says Dr. Shane. Ingrowns happen when a nail is cut too short or its corners are rounded with a file, or when there's too much pressure from shoes. Sports in which you frequently start and stop, like tennis or basketball, can jam toes and cause ingrowns. Soak your foot in an Epsom salt bath to help relax the tissue, decrease inflammation and separate the nail from the skin a bit, Dr. Shane recommends. If it gets infected, see your doctor, who can remove just the part of the skin that's ingrown. To prevent them, trim toenails straight across and leave them slightly longer than the end of the toe.

Hammertoe

Imagine that your toe looks more like a claw than a human appendage; hammertoe is a condition in which one or both toe joints are bent and the toe points toward the floor. "The muscles that control your toes get out of balance and force the toe to bend into an odd position at one or more joints," says Dr. McAloon. The most common cause is too-tight shoes, though some people can be more prone to it because of an inherited foot type. It's not necessary to correct a hammertoe (with surgery) unless it causes you pain or interferes with daily activities, Dr. McAloon says. There are things you can do at home to help, such as avoiding pressure on the toes, wearing shoes with a roomy toe box and applying a topical pain-relieving gel to ease aches.

Photos, from top to bottom: Thinkstock, Thinkstock, Shutterstock, Thinkstock, Thinkstock. Dave & Les Jacobs/Getty Images

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Soothe Your Joints

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How can I protect my joints while jogging or running?
Try to land on your feet as lightly as possible by tightening your core muscles (back, buttocks and abs) as your feet hit the ground. Practice jumping in place and landing so lightly that you hardly make a sound. Wearing gel inserts in your sneakers also can help absorb some of the impact. As for supplements, the research on chondroitin and glucosamine looks good, but it's too soon to say for sure that they work.

I'm 41. Is that too young for knee replacement surgery?
Joint replacement at your age is really a last resort. It's major surgery, and you'll probably need another surgery 10 to 15 years down the line to replace the new joint (maybe sooner if you're very active or overweight). But if you've already tried everything else—exercise, physical therapy, losing weight if you need to—and the pain is so bad that it's interfering with your daily life, then surgery may be worth it. Ask your doctor if it's possible to replace just part of your knee; it's less invasive and recovery time is faster.

My foot has been hurting for weeks, but I can still walk on it. Could it be broken? 
Yes, so stay off it as much as possible and get to an orthopedist ASAP for an X-ray or bone scan. Pain and swelling that lasts for a week or more is a red flag that you may have a stress fracture, which is caused by placing repeated force on a bone. If this is the case, you may need crutches and/or a brace.

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Checkup: Rheumatoid Arthritis

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What's the difference between rheumatoid and osteoarthritis? 
When you think of arthritis, you probably picture joints that start aching as you get older and worsen thanks to excess weight or lack of physical activity (or too much high-impact activity). That's the case withosteoarthritis, the most common form. Rheumatoid arthritis (RA), on the other hand, is an autoimmune disease in which your body mistakenly attacks the tissues in your joints, eating up cartilage and bone. RA tends to affect small joints, namely the wrists and the knuckles of the hands and feet (osteoarthritis usually occurs in the knees, hips or back). No one knows what causes RA, but having a family member with the condition increases your risk, as does smoking.

What does it feel like? 
"Imagine morning stiffness that lasts all day," says Patience White, MD, chief public health officer for the Arthritis Foundation. RA causes inflammation, so the joints of your hands and feet are red, swollen and painful to move. Some sufferers initially have a lowgrade fever and no appetite. To make a definitive diagnosis, a rheumatologist examines you and may order blood tests to measure proteins and antibodies that are linked to RA.

How is RA treated? 
There's no cure, but RA is less likely to lead to disability than it was in the past—especially if it's treated early. Drugs such as methotrexate, Enbrel, Humira and Remicade are commonly prescribed to slow the progression of the disease and ease the pain. If initial treatments don't work, newer drugs like Orencia or Rituxan may help.

What else works? 
Staying at a healthy weight (extra pounds put more pressure on the joints) and exercising (to keep muscles and joints strong and limber) will ease pain and inflammation. Swimming and water aerobics are good choices since they don't put too much strain on your joints. Taking a self-help class (the Arthritis Foundation has a program) can also help you better manage the condition. Learn more at arthritis.org

Did you know? 
Swimming helps ease RA discomfort; studies are underway to see if yoga and tai chi can do the same. l RA affects more than twice as many women as men, and experts are seeing those numbers go up. l Symptoms usually start in your 40s and 50s, but children and younger adults can also develop it.

A Note from the Editors: 
Thank you all for your comments. We know that RA can cause severe pain, suffering and disability and certainly didn't want to undermine that fact. This online story ran as a one-page article in the magazine under our "Checkup" column. The column (and story) is designed to provide a basic primer and is aimed primarily at people who are not familiar with the condition. It's factually correct and the author interviewed a top rheumatologist. That being said, there are limitations to what we can cover in such a short amount of space. If we cover RA in the future, we hope to include real-life patient stories and provide more detailed information.

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When Your Body Turns Against You

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Lisa Hubbell suffered from bone-deep fatigue even though she slept 10 or 11 hours a day. But her son had just started kindergarten, she had recently finished a 60-mile breast cancer walk and was busy with work, so she just chalked up her exhaustion to a hectic life. But when the fatigue didn't let up and she developed joint pain a few months later, she knew something was really wrong.

In December 2002, Lisa saw a specialist who gave her a diagnosis: rheumatoid arthritis, an autoimmune disorder in which the body attacks the joints, causing them to become stiff, swollen and incredibly painful. She took steroids, which did ease the painful joint inflammation. "But they made me jittery, cranky and fat," says Lisa.

Over the next four years, Lisa tried a slew of other medicines that are known to help rheumatoid arthritis, but for her, they either worked temporarily or not at all. Then she read about an experimental new treatment, Rituxan, and the minute it was approved for rheumatoid arthritis in 2006, Lisa's doctor prescribed it to her. In just weeks, Lisa was able to get back to an almost-normal life of cooking, gardening and working as a freelance writer. "I'm a scrapper," says the 44-year-old, who lives in the Seattle area. "Rituxan gave me the ability to fight again."

Lisa is just one of an estimated 14 to 23 million Americans—three-quarters of whom are women—who suffer from autoimmune disorders, a group of 80 or more conditions (including type 1 diabetes, lupus, rheumatoid arthritis, psoriasis and multiple sclerosis) in which your immune system basically turns against you and attacks healthy organs and tissue.

But there's promising news: Thanks to a greater awareness of how widespread these disorders are—they're almost as common as cancer and heart disease—doctors now understand more about what causes them and have developed better diagnostic tools and treatments.

"It used to be that treatment of autoimmune diseases relied on one of two principles," explains Noel R. Rose, MD, PhD, director of the Center for Autoimmune Disease Research at Johns Hopkins University in Baltimore. "We either replaced the functioning of the damaged organ, as we do with the thyroid gland in thyroid disease—or suppressed the whole immune system, as we do in lupus and rheumatoid arthritis. But now we've developed drugs that target the specific parts of the immune system that are responsible for the disease."

Why the increase?

During the last few decades, the number of people with autoimmune disorders has skyrocketed. Certainly more people are being diagnosed, but that's not the only reason. Some experts believe the dramatic uptick is in part due to the increase of pollution and chemicals in the environment, which activate your immune system in much the same ways that infections do. Other researchers think that the obesity epidemic comes into play—obesity can cause inflammation, which can prompt the immune system to attack the body. Another potential culprit: being "too clean." The so-called hygiene hypothesis is based on the notion that when you're not exposed to viruses, bacteria and other germs, your immune system develops differently. When it is exposed to these things, it may respond in a way that predisposes you to an autoimmune condition, says Anne Davidson, MD, a rheumatologist at the Feinstein Institute for Medical Research in New York.

Because autoimmune diseases affect three times as many women as men, scientists suspect that the hormone estrogen may also play a role, says Betty Diamond, MD, chief of the Autoimmune Disease Center at North Shore Health System in New York. And although it's still unclear whether stress causes or simply exacerbates autoimmune disorders, research suggests that constantly elevated stress hormones can impair the immune system. In fact, numerous studies of people under chronic stress show they have much higher levels of a protein that causes inflammation.

Exposure to certain viruses like Epstein-Barr can also prompt the body to damage its own cells. "These infections can linger in our bodies long after we've recovered from the original illness and cause the immune system to mistakenly attack itself as a foreign invader," says John Harley, MD, PhD, chair of the Arthritis and Immunology Research Program at the Oklahoma Medical Research Foundation in Oklahoma City.

One thing experts do know for sure is that your genes play a role. "About one-third of your risk of developing an autoimmune disease is inherited," says Dr. Rose.

A faster diagnosis

Because symptoms of autoimmune disorders like pain and fatigue are hard to measure, and others like inflammation and weight gain or weight loss can be caused by many other diseases, getting a diagnosis can be tough. But one discovery has become a useful early warning: Certain genes and combinations of genes have been linked to these conditions. "We hope that in the next 10 years there will be a genetic test that can predict who's at higher risk for autoimmune disorders, so we can do more aggressive screening on those people and treat them before irreparable damage has been done," says Dr. Rose. (Actually experts can already do this with type 1 diabetes. "In families with a diabetic child, we can put together genetic information on the 'normal' sibling, test him or her for antibodies, and predict with a fair amount of certainty whether he or she is going to develop diabetes in the next five years," he explains.)

Doctors also now have a clearer understanding of the results of a blood screening called the antinuclear antibody test, which detects if you're making antibodies against your own cells. And even though a problem with diagnosing many (but not all) of these disorders is that there isn't one specific test to detect them, experts are much better at spotting the abnormalities that they can cause, says Josiah Wedgwood, MD, chair of the Autoimmune Disease Coordinating Committee at the National Institutes of Health.

Better treatments

All of these discoveries have led to the development of a new class of drugs called TNF (tumor necrosis factor) inhibitors, which stop the signals that cause inflammation. "TNFs are a real conceptual step forward, since they don't suppress the entire immune system and cause the health issues and side effects other medications can," says Dr. Rose.

"For many autoimmune diseases, the existing treatments we have work—like thyroid replacement hormone for thyroid disease and insulin injections for diabetes," adds Dr. Diamond. "But for the harder-to-treat disorders and people who can't tolerate steroids, these drugs give new hope. Instead of being destined for a wheelchair, patients can stay independent and even keep working. They've really transformed people's lives."

Protect your immune system

Maintain a healthy weight. Obesity can cause inflammation in the body, which can activate the immune system.

Don't smoke. Research shows that it doubles your risk of rheumatoid arthritis, and experts think it probably increases the odds of developing other autoimmune conditions.

Exercise. It strengthens your immune system and lowers levels of stress hormones. Plus, regular low-impact exercise—walking, cycling, swimming—may reduce the often-debilitating fatigue that comes with autoimmune disorders like lupus, rheumatoid arthritis and MS, according to recent studies.

Go green when cleaning. It will reduce your exposure to chemicals.

The new drugs

Humira (adalimumab) 
TREATS rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, ankylosing spondylitis (a form of arthritis) and moderate to severe psoriasis. Also for Crohn's disease if other treatments don't work. 
GIVEN AS an injection, usually every other week.

Enbrel (etanercept) 
TREATS rheumatoid arthritis, moderate to severe psoriasis, psoriatic arthritis, ankylosing spondylitis, juvenile arthritis. 
GIVEN AS an injection once a week.

Remicade (infliximab) 
TREATS rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, Crohn's disease, ankylosing spondylitis and severe psoriasis. 
GIVEN AS an intravenous infusion at intervals of several weeks.

Cimzia (certolizumab pegol)
TREATS moderate to severe Crohn's disease in adults who haven't been responding to conventional therapy. 
GIVEN AS injections once every four weeks.

Rituxan (rituximab)
The drugs listed above are TNF inhibitors; this drug is what's called B-cell therapy. It targets cells that play a role in rheumatoid arthritis. 
TREATS rheumatoid arthritis; also being tested for multiple sclerosis. 
GIVEN AS two infusions separated by two weeks; repeated every six months.

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Bone Health Tips for Every Decade

It may seem like osteoporosis is just a part of aging, but it doesn't have to be. While it's true you lose bone strength and mass as you get older, there are many things you can do to lower your chances of getting osteoporosis. We've spoken with experts and gotten tips for keeping your bones strong during your 20s, 30s, 40s, 50s and 60s. Though this information is arranged by decade, and some advice—like that on estrogen replacement and bone density tests—definitely applies to that age group, tips on nutrition and exercise are important no matter what your age, and should be followed throughout your life.

In Your 20s

Hip fractures and loss of bone density are likely not on the minds of most 20-somethings, but this is when women need to start working on maintaining the bone strength they have. Marjorie Luckey, MD, medical director at Saint Barnabas Osteoporosis Center in Livingston, New Jersey, says women reach their peak bone mass by their early 20s. This means you have to start working on maintaining what bone strength you have during this decade of your life. Women in their 20s should:

1. Avoid smoking. Smoking cigarettes hampers the work of bone-building cells and increases your risk of developing osteoporosis.

2. Exercise properly. Weight-bearing exercise (this can include simple activities like walking) is strongly recommended throughout your life in order to keep up bone strength. But, as with most things, moderation is key. Nathan Wei, MD, clinical director of the Arthritis and Osteoporosis Center of Maryland, says woman who have extreme exercise habits—to the point where they develop amenorrhea (loss of menstrual cycle)—trick their bodies into thinking they are going into menopause, a major risk factor for osteoporosis.

3. Watch your weight. During your 20s, you may only be concerned with keeping your figure trim, but a healthy body weight should be the goal instead. Being underweight is a high risk factor for osteoporosis. (Underweight is defined as a body mass index (BMI) of less than 18.5 kg/m2.) To find out your BMI, go to WomansDay.com/BMI.

4. Consider a vitamin D supplement. Vitamin D is important for every stage of life because it helps your body absorb calcium, which is very important for bone health. "There is an epidemic of vitamin D deficiency in the U.S.," says Dr. Luckey. "We get a lot less vitamin D than past generations because we are out in the sun less." She advises that women, especially those living in the Northeast, who don't receive as much sunlight as their Southern counterparts, take a vitamin D supplement to reach the recommended 600 to 800 IU per day. Foods such as fatty fish and milk as well as some juices contain vitamin D, but not in large enough doses to get as much as the body needs.

In Your 30s

For many women this is the decade when their focus is on building a career and starting a family. Both of these can have an effect on overall bone health. Women in their 30s should:

1. Keep salt and caffeine in check. Too much of either can promote calcium loss. Lanah J. Brenna, a registered dietician at Reactive Nutrition in Lafayette, Louisiana, advises women to limit their sodium intake to 1,300 mg a day and caffeine to 200 to 300 mg a day to help reduce bone loss.

2. Limit drinking. Excessive alcohol consumption (more than two drinks a day) has been linked to increased risk of hip and other osteoporotic fractures.

3. Consider a calcium supplement. Adult women should get about 1,000 mg of calcium a day. If you're pregnant or nursing, you should bump up your intake to 1,200 mg a day. Dr. Luckey says that most people naturally consume about 300 mg of calcium a day. Adding yogurt or lowfat cheese to your diet will help increase your numbers. "Calcium is listed on nutritional labels as a percentage; to convert that to milligrams, just add a zero," advises Dr. Luckey. If you calculate how much calcium you're getting and you still come up short, add a supplement—most contain between 200 to 600 mg.

4. Learn your family history. Find out if your mother, grandmother, aunts or sisters have (or had) osteoporosis, fractures or any other related health issues. Heredity plays a big part in assessing your risk. If you know you have a family history of osteoporosis, then you can talk to your doctor about what measures (such as earlier bone density testing) you may need to take.

In Your 40s

Hopefully you've established healthy habits during your 20s and 30s. If not, don't underestimate how important this time of your life is. Kick your fight against bone loss up a notch before you reach your high-risk 50s. Women in their 40s should:

1. Add weight training to your exercise routine. You should already be doing at least 30 minutes of physical activity a day, like walking, gardening, golfing, swimming, tennis or dancing. But now's the time to add strength training to your workout routine. Staying active throughout your life helps your bone health by increasing muscle mass, strength, balance and coordination.

2. Consider other health risks. Talk to your doctor about how other health problems such as diabetes, depression and intestinal disorders affect bone health. Also discuss how some medications as well as more intense medical treatments, like chemotherapy, can alter your body's ability to absorb calcium.

3. Figure out your fracture risk. The World Heath Organization has a tool called FRAX that helps you figure out your risk for getting a fracture over the next 10 years. Simply enter your age, height and weight, then answer a few questions about your family history and lifestyle to get recommendations for treatment.

In Your 50s

Your 50s are a time of change—the most important of which is the beginning of menopause. Dr. Luckey says that the 3 to 5 years after menopause are the most important in terms of bone density loss. "Osteoporosis can occur at any age, and for a variety of reasons," says Elizabeth Ricanati, MD, staff physician in the Department of Disease Reversal at Cleveland Clinic. However, she points out that according to the National Osteoporosis Foundation (NOF), over half of the U.S. population develops osteoporosis after the age of 50. Women in their 50s should:

1. Up your vitamin intake. The NOF recommends that adults age 50 and over get 1,200 mg of calcium daily. If you are postmenopausal and not taking hormones, the dosage increases to 1,500 mg a day. It's also recommended that adults 50 and over get more vitamin D (1,000 to 2,000 IU daily).

2. Consider estrogen replacement. Once you go though menopause, your body loses estrogen. Dr. Luckey says that women with high risk factors or signs of osteoporosis often benefit from a low-dose estrogen patch. She sometimes recommends the drug Evista, which "mimics the effect of estrogen" in the bone.

In Your 60s

The decrease of estrogen in your body during your postmenopausal years is a major cause of bone density loss. While some bone loss after menopause may be inevitable, other factors, such as breaking a bone, can put some women at higher risk than others. Women in their 60s should:

1. Get a bone density test. According to Dr. Luckey, all women over 65 should get routine bone density tests. If you're under 65, postmenopausal and have high risk factors, such as a family history of osteoporosis or a broken bone after age 40, it's also recommended that you have regular bone density tests.

2. Protect yourself against falls. Wear shoes with nonslip soles, clear things from the floors that could be easily tripped over, keep hallways and corners well lit, use a stepstool with handrails and be careful with medications that affect your balance or make you drowsy.

3. Talk to your doctor about prescription medication. Depending on how advanced your bone loss is, your doctor may suggest you take medication to prevent further bone loss. Dr. Ricanati explains, "There are different classes of medications to treat osteoporosis, such as the bisphosphonates (Fosamax, Boniva, Actonel and Reclast), SERMs (selective estrogen receptor modulators), estrogen/progestin, parathyroid hormone and others." Dr. Wei also points to a new treatment, denosumab, which is recommended for women who experience side effects from bisphosphonates. As with any prescription drug treatment, there are risks associated with most medications, and the best avenue is always prevention.

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