Osteoporosis, Menopause and You
Hormone balance is essential throughout life, and certainly for any woman concerned about the risk for osteoporosis.
Osteoporosis is a disease that weakens bones, increasing the risk of sudden and unexpected fractures. Literally meaning “porous bone,” osteoporosis results in an increased loss of bone mass and strength.
The disease often progresses without any symptoms or pain so that many times, osteoporosis is not discovered until weakened bones cause painful fractures usually in the back or hips.
Unfortunately, once you have a broken bone due to osteoporosis, you are at high risk of having another. And these fractures can be debilitating.
Fortunately, there are steps you can take to help prevent osteoporosis from ever occurring. And treatments can slow the rate of bone loss if you already have osteoporosis.
What Causes Osteoporosis?
Though we do not know the exact cause of osteoporosis, we do know how the disease develops.
Your bones are made of living, growing tissue. An outer shell of cortical or dense bone encases trabecular bone, a sponge-like bone. When a bone is weakened by osteoporosis, the “holes” in the “sponge” grow larger and more numerous, weakening the internal structure of the bone.
Until about age 30, we normally build more bone than we lose. During the aging process, bone breakdown begins to outpace bone buildup, resulting in a gradual loss of bone mass.
Once this loss of bone reaches a certain point, you have osteoporosis.
How Is Osteoporosis Related to Menopause?
There is a direct relationship between the rapid loss progesterone and of oestrogen during perimenopause and menopause and the development of osteoporosis.
Early menopause (before age 45) and any prolonged periods in which hormone levels are low and menstrual periods are absent or infrequent can cause loss of bone mass.
What Are the Symptoms of Osteoporosis?
Osteoporosis is often called a “silent disease” because initially bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse.
Collapsed vertebrae may initially be felt or seen in the form of severe back pain, loss of height, or spinal deformities such as stooped posture.
Who Gets Osteoporosis?
Important risk factors for osteoporosis include:
Age. After maximum bone density and strength is reached (generally around age 30), bone mass begins to naturally decline with age.
Gender. Women over the age of 50 have the greatest risk of developing osteoporosis. In fact, women are four times more likely than men to develop osteoporosis.
Women’s lighter, thinner bones and longer life spans account for some of the reasons why they are at a higher risk for osteoporosis.
Bone structure and body weight. Petite and thin women have a greater risk of developing osteoporosis in part because they have less bone to lose than women with more body weight and larger frames. Similarly, small-boned, thin men are at greater risk than men with larger frames and more body weight.
Family history. Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may be at greater risk of developing the disease.
Prior history of fracture/bone breakage.
Certain medications. The use of some medications, such as the long term use of steroids (like prednisone) can also increase your risk of developing osteoporosis. Know the high risk medications.
Steroids, some breast cancer treatments (such as aromatase inhibitors), drugs used to treat seizures (anticonvulsants), blood thinners (anticoagulants), and thyroid medications can increase the rate of bone loss.
If you are taking any of these drugs, speak with your doctor about how to reduce your risk of bone loss through diet, lifestyle changes and, possibly, additional medication.
Some medical conditions: Some diseases including cancer and stroke may increase your risk for osteoporosis.
How Do I Know if I Have Osteoporosis?
A painless and accurate test can provide information about bone health and osteoporosis before problems begin.
Bone mineral density (BMD) tests, or ultrasound can be indicated for women age 65 and older, those with numerous risk factors and menopausal women who have had fractures.
How Is Osteoporosis Treated?
Treatments for established osteoporosis (meaning, you already have osteoporosis) include:
Medications such as alendronate (Binosto, Fosamax), ibandronate (Boniva), raloxifene (Evista), risedronate (Actonel, Atevia), and zoledronic acid (Reclast, Zometa).
These are often linked to unpleasant side-effects, so do check the information that comes with this medication and discuss with your doctor.
Alternatively you could investigate the benefits of bioidentical hormones, progesterone in particular, and the use of a good bone building supplement containing vitamin D, calcium, calcium vitamin K2, magnesium, silica and boron.
Osteoporosis requires good levels of two specific female hormones: oestrogen which breaks down old bone, and progesterone which builds new bone.
If you only have oestrogen then you are gradually breaking bone down but are not providing the conditions for the new bone to be built. This can lead to the bone having a series of holes, a lace like structure which is more brittle and more vulnerable to breakage.
How Can I Prevent Osteoporosis?
There are multiple ways you can help protect yourself against osteoporosis, including:
Hormone supplementation. If you have an excess of oestrogen, and not producing sufficient progesterone to build new bone, then you can be increasing your risk of developing osteopenia or osteoporosis.
For the majority of women at menopause low progesterone levels affect a number of conditions, so supplementing with bioidentical progesterone can be helpful not just for osteoporosis, but it is certainly essential in helping with that condition.
Exercise. Establish a regular exercise programme. Exercise makes bones and muscles stronger and helps prevent bone loss. It also helps you stay active and mobile.
Weight-bearing exercises, done at least three to four times a week, are best for preventing osteoporosis. Walking, jogging, playing tennis, and dancing are all good weight-bearing exercises. In addition, strength and balance exercises may help you avoid falls, decreasing your chance of breaking a bone.
Nutrition. A good balanced diet with foods high in calcium and vitamin D including:
Dairy foods – milk, cheese and yogurt
Green leafy vegetables – broccoli and cabbage (not spinach)
Nuts and seeds – particularly chia seeds and almonds
Fatty fish – sardines and salmon
Beans and lentils – kidney beans, black beans and chickpeas
Your body uses vitamin D to absorb calcium and being out in the sun for a total of 20 minutes every day helps most people’s bodies make enough vitamin D.
You can also get it from eggs, fatty fish like salmon, cereal and milk fortified with vitamin D, as well as from supplements. People aged 51 to 70 should have 600 IU daily.
More than 4,000 IU of vitamin D each day is not recommended. Talk to your doctor to see how much is right for you because it may harm your kidneys and even lower bone mass.
Other preventive steps. Monitor your hormone levels for symptoms to ensure you are not oestrogen dominant. Limit alcohol consumption and do not smoke. Smoking causes your body to make less oestrogen, and too much alcohol can damage your bones and increase the risk of falling and breaking a bone.
If you have osteoporosis, it is very important to protect yourself against accidental falls, which may result in fractures. Take the following precautions to make your home safe:
- Remove loose household items, keeping your home free of clutter.
- Install grab bars on bath and shower walls and beside toilets.
- Have good lighting in all areas
- Remove trip hazards such as rugs.
How Weight-Bearing Exercises Help Strengthen Bone
Weight-bearing exercises are activities that make your muscles work against gravity. Walking, hiking, stair-climbing, or jogging are all weight-bearing exercises that help build strong bones.
Thirty minutes of regular exercise (at least 3 to 4 days a week or every other day) along with a healthy diet may increase peak bone mass in younger people. Older women and men who engage in regular exercise may experience decreased bone loss or even increased bone mass.
Because osteoporosis can be fatal if left untreated, it is good to be aware of all the factors you can personally address to reduce your risk.
Dame Dr Shirley Bond offers excellent advice in the article below.