Bloomberg Audio Studios podcasts, radio,

news.

>> You're listening to Bloomberg Business

Week with Carol Masser and Tim Stenc on

Bloomberg Radio.

>> About half of women and 20% of men over

50 break a bone because of osteoporosis.

Yet, many people with the condition

don't get treated. But late last year,

we did see the Food and Drug

Administration making an important

policy change that is expected to spark

new interest in treating the common bone

disease.

>> So instead of waiting years to see

whether clinical trial participants

experience fewer fractures, drug makers

can now measure whether their medicine

increases bone mineral density. It'll

take make clinical trials much shorter

and cheaper. But it's expected to entice

more biotech companies to pursue new

drugs and investors to back them. And

it'll be interesting about the

differences, men versus women, because

we know we've talked about that a lot in

this se segment. Let's get to it. It's

time for the business week women's

health segment. We focus on key issues

in developing technologies impacting the

present and future of women's health

around the world. Delighted to have with

us Dr. Doug Lucas. He's an orthopedic

surgeon, osteoporosis specialist at the

telealth platform, LifeMD joining us

here in studio. Welcome. Welcome.

>> Thank you. Happy to be here.

>> It's good to have you here. I don't

think we talk about it a lot, but I

think we should. tell us about this

condition and why you chose to focus on

it especially when it comes to health,

bone health in women.

>> Uh well I mean first of all thank you

for letting me talk about it because

you're right we don't talk about it

enough.

>> Um osteoporosis as you mentioned has a

very high morbidity rate meaning the

problems that come along with fracture

is very high meaning you could

potentially die after a fracture. A

third of women and men after a fracture

will actually pass away within 12

months. the loss of

>> why is that?

>> Wow.

>> Because you sound like people get

fractures and they deal with it. Why?

>> So, it a lot of it has to do with who is

actually having fractures. Some of these

patients are older. They're very frail

to begin with. But we're actually seeing

fractures younger and younger too. And

so, while the mortality, the death rate

is very high and alarming, it's actually

the loss of independence that I think is

more important. And not that not that

death isn't important, but we see so

many women especially lose independence

much earlier in life than we would

anticipate and it catches them offguard

because we're not talking about it and

we're not screening.

>> Well, I feel like orthopedic surgeons,

you you often see an orthopedic surgeon

for the first time when you've already

had an injury. You know, you're going in

because you need something fixed and

that doesn't sound like we're we're

we're prepping in the right way or or

avoiding this in the right way. So, what

should we be understanding? what should

we be talking about? What should we be

doing to actually prevent having to go

see you?

>> So, there's two huge things here. No,

it's fine. I actually don't operate

anymore because I actually am now in the

game of prevention. I want to educate. I

want to prevent.

>> Um, and so there's two main things to

think about here. One is screening. So,

screening earlier. Right now the

recommendations from some of the

governing bodies like the USPSTF, United

States Preventive Services Task Force

recommend screening for women at 65 and

men for 70 if they have risk factors.

>> That seems old.

>> It is way too late. And I understand

they do it because of the statistics and

I get it.

>> But we should be screening especially

women through midlife parmenopause and

menopause because that is the opportune

time to intervene especially when we

talk about hormone therapy. Well, let's

go there because I feel like in the last

year or so, we've had a whole like kind

of enlightenment about some of the

research that's been done when it comes

to women in um hormonal therapy. So,

what have we learned and what do we need

to know now going forward?

>> Well, this is a really fun space for me

to talk about because this is where we

get to talk about hormones in a

different light. For the last 20 plus

years, we've been living in this sort of

fear. Use as little hormone as possible,

only treating symptoms. Those are what

the guidelines actually still say for

the most part is treat symptoms of

menopause. But when you look at hormones

through the lens of bone health, we have

the opportunity to start saying, "Wait a

minute, the lowest dose that treats your

symptoms might not actually be enough to

treat your bones to prevent bone loss."

And yet estradiol estrogen is FDA

approved for the prevention of

osteoporosis. But if we're not measuring

it, then we don't actually know that

it's doing what we want it to do. And

this is where we have to get into a new

space of hormone optimization rather

than just hormone replacement or

menopausal hormone therapy.

>> What happens to people who've like

missed that window like I think about I

mean this is where okay every day we're

learning how to treat various ailments

um across the spectrum if you will. So

what happens for those who've missed out

and obviously we're getting enlightened

about for the next generation if you

will.

>> Sure. There there's a lot of opportunity

to talk to different groups of women

here. for the women that went through

menopause over the last 20 plus years.

Many of them are traditionally quote

unquote beyond the the window of

opportunity which is within 10 years

from menopause, right? I talk to a lot

of these women in their 60s and 70s

every day and they are angry that they

didn't have that conversation that that

was that opportunity was robbed from

them. But at the same time, the research

actually supports there is opportunity

for some of these women, especially the

women 10 to 20 years from menopause. So

this is most women in their 60s. It's

not necessarily too late. We just need

to take individual risk factors into

consideration. A lot of doctors

unfortunately are still treating as if

anytime after 10 years out from

menopause is too late.

>> That's what I feel like. I mean, as a

woman, as the mother of a daughter, you

know, it is fascinating um to see I have

a 23 23 year old daughter like going

into various medical offices and how

they're treated, how we're treated. It's

not always so ideal in terms of being

open to what you say about yourself or

the questioning of well maybe that's you

know not kind of really thinking about

the diagnosis and maybe pursuing what's

wrong.

>> I think you're saying it nicely.

>> I'm trying to be careful here but you

know what I'm saying.

>> Absolutely. No, absolutely. It's really

>> why is that still

>> I think there's a lot of reasons. I

think for a lot of uh for most of modern

medical history, we have not treated

women as individual. You know, women are

different than men. Yeah. The the sexes

are different. Women have different

needs than men's. And the research shows

that research has mostly been done on

men until very recently. There's very

little funding for women in medical

research, even currently.

>> Amazing.

>> And so doctors, I think, for the most

part, mean well. they want to treat

their patients but a lot of times they

don't actually have the tools they need

or the knowledge they need to treat a

woman as a woman which is really

unfortunate. On top of that there is

this underlying um just paternalistic

nature of physicians that when it comes

to women we tend to tell them what to do

versus when it comes to men we tend to

educate them on the risks and let them

decide.

>> Is this being taught in med school these

days at all?

>> Which part? like what you just mentioned

like what we've tended to do and what

physicians have tended to do and a ways

to avoid that bias in when it comes to

treatment.

>> Not in my medical school training. No,

we we we do learn from our mentors

though, right? So these these these are

how things get passed along from

generation to generation in medicine.

This is how these biases keep get passed

down.

>> Uh real quickly, got about 40 seconds.

Uh I'm going to go three things. Calcium

and vitamin D important.

>> Yes, but it's just one part of the

bigger picture. Uh doing weights

>> absolutely important.

>> What's the other part of the picture

that people should be thinking about

here?

>> Get screened early. Optimize hormones

resistance training and impact if you

can do it. That's the recipe. And food

whole food diet.

>> Peptides.

>> That's a longer conversation. The answer

is maybe. Uh there's a lot of research

coming though.

>> Okay. Will you come back?

>> Absolutely.

>> All right. That would be great. Um so

appreciate it. Uh that of course is Dr.

Doug Lucas, orthopedic surgeon,

osteoporosis

uh osteoporosis

specialist. Say that five times fast. Uh

at the tele health platform, it is of

course Life MD.