Women face unique challenges when it comes to bone and joint health—but they also have powerful tools to protect and strengthen their bodies at every stage of life. To shed light on this important topic, we spoke with Dr. Noelle DiGioia Guthrie, an orthopaedic surgeon with a passion for women’s health and a legacy of healing in her family. In this interview, Dr. Guthrie shares her insights on gender-specific risks, exciting innovations in orthopaedic care, and how women can stay strong and active through their entire lives.
Q: Are there orthopaedic concerns that are more common in women than men?
Yes, due to the hormonal differences in women and men, women are, in general, at a higher risk for developing osteopenia and osteoporosis. For this reason, they are also at higher risk for sustaining fragility fractures. Orthopaedic literature also has shown that women less commonly seek treatment for their osteoarthritis and are more likely to wait to undergo total joint replacement surgery than their male counterparts.
Q: What advancements in orthopaedics are you most excited about right now?
Advancements in robotics and navigation in total joint replacement surgery have made great strides over the past few years. Additionally, the advances in general in total knee and hip implants have made the longevity of these implants much longer and more reliable.
Q: How can women prioritize bone and joint health throughout their lives?
Women can prioritize their bone and joint health through many facets. They can remain up to date with their primary care services and preventative services– namely monitoring calcium and vitamin D levels, as well as getting DEXA scans. If there is joint pain and any concern, they should be evaluated early by x-ray imaging and by an orthopaedic specialist. Lastly, maintaining a healthy weight and practicing daily movement or exercise is important for maintaining healthy bones, muscles, and joints.
Q: Can you share a particularly memorable case or patient that reinforced why you chose this career?
I traveled with the Pittsburgh Operation Walk team as a medical student and was able to scrub into a total knee replacement for the first time with my dad. While it was a very memorable experience being able to operate with my dad, I found the surgery itself to be such an intense yet precise procedure requiring as much finesse as it does strength. I was able to see the x-rays and patients walking with physical therapists post-op. The patients stated how thankful and happy they were to be mobile and pain-free. This sparked my interest and desire to pursue orthopaedics and especially adult reconstruction as a specialty. The profound positive effect it has on patients’ lives is amazing.
Q: How does women’s bone and joint health differ across the lifespan—from childbearing years to menopause and beyond?
Typically, women achieve their peak bone mass around the age of 30, and due to hormonal changes, it tends to decrease steadily after that. Pregnancy, breastfeeding, and then menopause also cause changes in hormones which then again change the overall bone mass. This is a delicate balance between bone resorption and building bone. In general, hormone replacement therapy (HRT) and estrogen are protective of bone quality and can help prevent fragility fractures. However, HRT has adverse side effects and is not for everyone, so it should be discussed with your PCP or endocrinologist prior to starting.
Final Thoughts:
Dr. Guthrie’s expertise highlights just how vital it is for women to take charge of their bone and joint health early and often. From staying active and getting regular screenings to embracing the latest surgical advancements when needed, women have more resources than ever to support strong, healthy movement. As Dr. Guthrie reminds us, it’s never too early—or too late—to prioritize strength, mobility, and lifelong wellness.
