'I remember crying my eyes out': The diagnosis Kristy never expected to receive at age 26

Sydney woman Kristy Dawkins was just 26 when she was diagnosed with osteopaenia following a bone density scan.

The condition, a precursor to the more severe osteoporosis, followed an earlier diagnosis of hypothalamic amenorrhea (HA), which is characterised by a loss of the menstrual cycle.

Despite consulting numerous doctors, Dawkins was for years unaware the loss of her period was the result of HA, or that it in turn would in turn one day lead to poor bone density.

Now, the former world champion power lifter is warning other women about the condition in the hope they can protect their own bone health.

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Dawkins had a regular period for two years until it stopped suddenly at 15.

She now knows she was suffering from hypothalamic amenorrhea (HA) due to extreme weight loss.

According to The Medical Journal of Australia, hypothalamic amenorrhoea is a common but often misdiagnosed condition in which prolonged oestrogen deficiency causes bone loss and other health problems.

"At 15, I lost 13 kilos," Dawkins recalls.

"I was not feeding my body enough, which made my period stop."

Dawkins was in her late teens when she first sought medical help but said she was never told her lack of periods was linked to her diet or weight training.

"It is very common that women with HA are told to come back when they want to have kids or just told to go on the pill," she said.

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She was finally diagnosed with HA in her early 20s and told to go on hormone replacement therapy, but gave it up after nine months due to the cost. She said at that point she was still unaware of the effect on her bone density.

It was only years later when she visited a fertility specialist for a check-up in the lead-up to starting a family with her now-husband that the specialist sent her for a bone mineral density (BMD) scan. 

While normal bone density for a woman is -1 to 1, Dawkins' was -2.4. A score of -2.5 indicates osteoporosis.

"It was the biggest shock to my system," Dawkins recalls of the moment in January 2018.

"I just remember crying my eyes out in the middle of the hospital."

According to Australia's HealthDirect website, osteopaenia refers to lower than normal bone density, meaning bones are more fragile and more likely to break from minor accidents.

While bone density gets lower with age as a result of falling hormone levels, it is also linked to certain lifestyle factors, health conditions and medicines.

Dawkins's diagnosis was life-changing.

"I had just won the world record for power lifting. I had 10 world records and I was being told I had to stop," she said.

"It was like telling a painter to stop painting. It was so hard."

While women are told to lift weights to improve bone density, in Dawkins' case, the lack of oestrogen in her body meant her bones were becoming weaker, not stronger.

"I didn't have enough oestrogen to help with my bone regeneration," she said.

Dawkins was told to give up sport.

"I had to gain eight kilograms and I could only go for gentle walks."

She also had to change her mindset in relation to food and body image.

After two years, Dawkins' period finally returned and she was cleared to resume weight training, but at much lower levels.

Now 33, her bone density has improved but she will need to be vigilant to prevent osteoporosis.

"My bones have gotten better. I am still osteopaenic. I am better but it will never be what it should be for my age," she said.

She also needs to be extra vigilant if she becomes pregnant and as she ages, and must undergo bi-annual bone mineral density scans.

"I will be on a calcium and vitamin D supplement the rest of my life," she said.

Dawkins now works to raise awareness of HA and its effects on bone density.

"I wish I had someone telling me about HA and the effect on bone density 10 years ago. I do not want any other girl to go through this," she said.

"Women need to know about their bodies. If you do not have your period, get checked.

"I got dismissed by doctors so many times. If you don't get an answer, keep investigating."

Dawkins is also working with Healthy Bones Australia (HBA), which works to improve bone health and reduce broken bones.

The not-for-profit organisation is behind a report released this week which found there were 193,000 bone fractures in Australia in 2023, which is equivalent to one every 2.7 minutes.

The Deakin University report, "Osteoporosis and fractures in Australia – A burden of disease analysis 2023-2033" was launched at Parliament House, Canberra.

The report revealed 6.2 million Aussies aged 50 and over were living with poor bone health, which included osteopaenia and the more severe osteoporosis.

It found cases are expected to increase to 7.7 million by 2033.

Healthy Bones Australia chairperson Professor Peter Ebeling said two-thirds of Australians aged 50 and over had poor bone health.

"Moreover, a staggering 2.1 million fractures due to osteoporosis are estimated to occur over the next decade — representing one fracture every 30 seconds by 2033," he said. 

"If our current disease prevention, management and treatment strategies remain on the same trajectory over the next decade, the total cost of osteopaenia and osteoporosis will reach an estimated $67.9 billion."

Healthy Bones Australia medical director Professor Peter Wong said there needed to be earlier investigation of bone health through bone mineral density (BMD) testing and a greater emphasis on medical and lifestyle interventions. 

"Healthy Bones Australia is urging GPs to identify at-risk patients, and to intervene as early as possible," Professor Wong said. 

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