Bone Strength in Menopause

A sometimes hidden symptom of menopause is a decrease in bone density. There needs to be awareness of the critical issue of bone loss during menopause. By examining the causes and implications, people in perimenopause and menopause should know the effective prevention strategies and treatment options for their overall health.

Understanding these crucial aspects of menopausal bone health empowers women to take proactive steps in maintaining strong, resilient bones throughout this transformative life stage and beyond

What Causes Bone Loss During Menopause?

Beginning in perimenopause the body begins to produce less of the hormone oestrogen. While many people know oestrogen as a hormone that affects fertility and menstrual cycles, it plays a crucial role in maintaining bone density by regulating the balance between bone formation and resorption. As oestrogen levels drop, this delicate balance is disrupted, leading to accelerated bone loss.

Studies have shown that people in perimenopause and beyond can experience a 10-20% reduction in bone density. This dramatic decrease puts them at a significantly higher risk of developing osteoporosis, a condition characterised by fragile, porous bones. On average, women lose up to 10% of their bone density in the first 5 years after menopause, highlighting the importance of proactive bone health management during this period.

While oestrogen deficiency is the primary culprit, other factors can exacerbate bone loss during menopause. There are other factors that contribute to bone fragility that are exacerbated by the decrease in oestrogen production. While not directly related to menopause it is still important to know for overall bone health. These are issues like a family history of osteoporosis, smoking, consuming alcohol, the number of previous pregnancies, and physical activity. While not a hormone, the levels of calcium and Vitamin D also play a role in bone health and are important to consider during perimenopause and beyond.

Lifestyle Changes

It is important to speak with your doctor or a registered menopause healthcare professional when considering options for your bone health. In general, a calcium-rich diet is the essential foundation for bone health for people in perimenopause and menopause. The Singapore Medical Journal recommends for optimal bone health, women should have a total calcium intake of 1,000–1,500 mg/day, preferably through their diets. Supplementation of vitamin D of 600–800 IU/day is indicated in those with deficiency. The vitamins and minerals are found in food sources like fatty fish, egg yolks, and fortified products.

Regular exercise, particularly weight-bearing and resistance training activities, plays a vital role in maintaining bone density. One study published in the National Institutes of Health cites that these exercises stimulate bone retention and can even moderately increase bone mass. Other lifestyle factors that can be made to increase bone density are quitting smoking and limiting alcohol consumption, which both lead to bone fragility.

Additionally, quitting smoking and limiting alcohol consumption are crucial steps, as these habits can accelerate bone loss and heighten fracture risk.

Hormone Replacement Therapy

The Ministry of Health of Singapore indicates the hormone replacement therapy (HRT) remains an effective option for preventing osteoporosis, particularly for in perimenopause but can also help thereafter. HRT helps maintain bone density by replacing declining oestrogen levels. Hormone replacement therapy also has implications that need to be discussed with a registered healthcare professional.

Everyone has a different medical history and set of circumstances that make it vital to speak with a doctor or registered healthcare professional when considering medical treatments for bone health. For some people a hormone replacement therapy is used to counteract the effects of oestrogen on bone health. When speaking with a healthcare professional they may offer regular bone density scans These typically every two years, are essential for monitoring bone health and detecting any loss early, enabling timely interventions.

Pharmacological Interventions

Bisphosphonates are a class of drugs that are used to prevent osteoporosis for people in perimenopause or menopause. These medications work by slowing bone loss as oral tablets, or as intravenous infusions. Other medications besides bisphosphonates are available but should be given under the direction of a healthcare professional.

Getting All the Information

Bone loss during menopause presents a significant health concern, but it need not be an inevitable consequence during this time of life. Through a combination of lifestyle modifications, proper nutrition, and medical interventions when necessary, people can take proactive steps to maintain strong bones and reduce fracture risk. Regular exercise, adequate calcium and vitamin D intake, and hormone therapy or other medications prescribed by a healthcare provider can all play important roles in preserving bone density. By staying informed and working closely with medical professionals, people can navigate this transitional period with confidence, safeguarding their skeletal health and overall well-being for years to come.