Sarah Leyland is an osteoporosis specialist nurse with the Royal Osteoporosis Society, where she has played a central role in developing their nurse-led helpline and information services. With a background in women’s health, Sarah now works as a clinical advisor, lending her expertise to a range of projects that aim to improve public awareness, treatment, and support for those affected by osteoporosis. Her work addresses the unique challenges faced by women, who are at increased risk due to factors like hormonal changes around menopause and longer life expectancy.
“Fractures from osteoporosis can have a life-altering impact, but with the right knowledge and tools, we can empower people to protect their bone health and preserve their quality of life.”
A career journey focused on women’s health and osteoporosis
My journey into osteoporosis care began in women’s health, where I first started as a nurse. Early on, I recognised the unique challenges women face, not only in managing their health but in navigating specific health issues like osteoporosis. Over the years, my work has evolved to focus on bone health, a critical yet often overlooked area in women’s well-being. I joined the Royal Osteoporosis Society to help build a specialist nurse-led helpline and an information service, both of which are designed to educate, support, and empower people living with osteoporosis.
Today, my role has expanded to encompass clinical advisory work across many of the charity’s initiatives. On a daily basis, I provide guidance for our team of specialist nurses, respond to complex cases from callers on our helpline, and work on public health projects aimed at raising awareness about osteoporosis and advocating for better support. Every day is different; sometimes, I’m working directly with patients to provide information and reassurance, and other times, I’m collaborating with healthcare professionals to develop resources that support osteoporosis management across the NHS.
Understanding osteoporosis and its impact
Osteoporosis is often described as a ‘silent disease’ because, until someone experiences a fracture, they may not even know they have it. But those fractures can be life-altering, impacting people’s ability to move, live independently, and perform daily tasks. Bones lose strength and density over time, and when they become fragile, the likelihood of fractures increases. Common areas affected include the hips, spine, and wrists, and these fractures can lead to chronic pain, reduced mobility, and a severe loss of quality of life, especially for older adults.
In the UK, one in two women over the age of 50 will break a bone due to osteoporosis, compared to one in five men. Women are particularly vulnerable because we start off with smaller bone frames and experience rapid bone loss after menopause when oestrogen levels drop. This hormone plays a key role in maintaining bone density, so when it decreases, bones naturally become more fragile. And as women tend to live longer than men, we face additional years of bone weakening, making proactive care even more essential.
The impact of medical treatments on bone health
I also see more people who are managing multiple health conditions, and in some cases, the treatments for these conditions can inadvertently impact bone health. For instance, medications used to treat breast and prostate cancer can reduce levels of oestrogen or testosterone, which inadvertently weakens bones. Anti-inflammatory medications like glucocorticoids (steroids), used for conditions like asthma and arthritis, can also cause bone density to decline when taken in high doses or over long periods.
It’s a delicate balance; we’re helping people manage serious health conditions, yet we need to remain mindful of the side effects that may weaken bones. Educating patients and healthcare providers about this relationship is one of my core responsibilities, as it’s crucial to support people in maintaining bone health while they manage other aspects of their health.
Lifestyle factors and the importance of exercise
A huge part of what we do at the Royal Osteoporosis Society is raising awareness about the power of lifestyle choices in maintaining and even improving bone health. Diet, exercise, and healthy habits can play a transformative role in keeping bones strong. We encourage people to follow a well-balanced diet that’s rich in calcium and protein – both are essential building blocks for bone health.
Exercise, in particular, is incredibly powerful. I advise patients to incorporate weight-bearing impact exercises, like jogging, walking, or even activities as simple as skipping, which place beneficial pressure on bones. Resistance exercises, such as using weights, help to build muscle strength, which supports bone stability. While it can be challenging for people to fit exercise into their routines, especially for women with busy lives, it’s one of the most effective ways to slow down bone loss and maintain strength.
Additionally, we encourage other lifestyle practices that contribute to bone health, such as avoiding smoking, limiting alcohol intake, and maintaining a healthy weight. Adequate vitamin D from sunlight exposure is also essential, especially during the winter months when we see less sun. For those who cover up or don’t get outdoors as much, I recommend vitamin D supplements to ensure they’re getting enough of this crucial nutrient for bone health.
Treatment options and the role of hormone replacement therapy
For some people, lifestyle changes alone aren’t enough, and medication can play a crucial role in reducing the risk of fractures. As a nurse, I work with people to help them understand their treatment options, including hormone replacement therapy (HRT) for younger post-menopausal women at higher fracture risk. HRT can be incredibly effective in protecting bones, but there are individual factors to consider. For older women, for instance, HRT may come with increased risks for certain conditions, so each woman needs to make an informed choice based on her circumstances.
Alongside HRT, other bone-strengthening medications are available and can make a significant difference. At the Royal Osteoporosis Society, we’re currently developing a medication support programme to help people feel confident in their treatment choices. We want patients to have the information and support they need to feel empowered in managing their bone health and to understand how medication can help reduce their fracture risk.
Addressing the need for osteoporosis screening
A common question I hear is about screening. Unfortunately, there isn’t yet a formal screening programme for osteoporosis in the UK. Screening everyone over a certain age isn’t currently feasible or cost-effective. However, we’re exploring ways to better identify those at risk, potentially by using fracture risk assessments rather than bone density scans alone. The charity is very focused on supporting this research, as we’re committed to finding effective ways to help people understand their risk and take proactive steps.
The Royal Osteoporosis Society: Resources to support bone health
For those who want to learn more, the Royal Osteoporosis Society offers a wealth of information. Our website is packed with resources on everything from exercise and nutrition to treatment options. We also have an online risk checker, which I’m very proud of – it’s a simple tool that takes just a few minutes to complete and provides personalised insights into your osteoporosis risk, along with practical tips to improve bone health. Over 400,000 people have already used it, and it’s been an incredible way to help individuals take control of their bone health.
I’m also very excited about our Bone Matters programme, where we produce regular online films and interviews with experts. This is part of our commitment to ongoing education and to sharing the latest insights with our community. For those who want to support our mission, we offer a membership programme that helps fund the essential work we do while providing members with exclusive resources and events.
Looking forward: Upcoming projects and initiatives
We’re always looking for ways to improve support for people with osteoporosis. One of the upcoming initiatives I’m excited about is our medication support programme, launching next year. This programme will help people feel confident in their treatment choices, provide resources to aid in successful medication use, and ultimately empower people to prevent fractures and improve quality of life. It’s an exciting time to be involved in osteoporosis care, and I look forward to seeing how these initiatives make a difference.
Donations power life-changing research, and help people to be diagnosed and treated faster. To donate to the Royal Osteoporosis Society, visit: https://theros.org.uk/donate/make-a-donation/
