Osteoporosis and Menopause

Osteoporosis is perhaps the most serious symptom of menopause because it can lead to severe health problems such as chronic back pain and broken bones. Not only does osteoporosis threaten a woman´s physical health, but the disease can come on slowly and go unrecognized until a bone is fractured.

About 33% of women over 50 will experience bone fractures as a result of osteoporosis.

The hormonal fluctuations that precede menopause and the permanently low hormonal levels of post-menopause play a major role in the onset of osteoporosis.

There are treatment options available, but first it´s important to be educated about osteoporosis in order to know how to prevent and treat it.


About Osteoporosis

Osteoporosis is a disease that weakens bones and increases the risk of sudden and unexpected fractures. Osteoporosis literally means “porous bone.” A hallmark of the disease is an increased loss of bone mass and strength.

It often progresses without any symptoms or pain. Generally, osteoporosis is not discovered until weakened bones cause painful fractures usually in the back or hips. .

An unfortunate aspect of the disease is that once an osteoporotic fracture occurs, there is a much higher risk of additional bone fractures. More unfortunate news: women make up 80% of osteoporosis sufferers. The disease does affect men but at a drastically lower rate than women. This is because men generally have stronger, bulkier bones that don´t lose their mass as easily. Men who do suffer from osteoporosis generally get it later in life than women.

Because women are more susceptible to contracting osteoporosis, they have to take greater care to prevent or treat the diseases in their later years or before.


Calcium and Healthy Bones

The human body stores 99% of its calcium in bones and teeth. Like every part of the body, the bones are continuously regenerating themselves, losing cells and incorporating new ones. As bones grow, they rely on calcium as structural material to build the proper bone density.

Later in life, bones experience cell loss, where the amount of cells lost outnumbers the amount of new cells becoming part of the bones. Calcium is necessary not only during the teenage years and young adulthood when bones grow the most, but also later in life to retain as much bone mass as possible.


Calcium Recommendations

Children 1 to 3 years 500 mg
Children 4 to 8 years 800 mg
Youth 9 to 18 years 1300 mg
Adult 19 to 50 years 1000 mg
Adult 51 + years 1200 mg

Foods high in calcium:

    • Most dairy products  
    • Soy/rice milk  
    • Chinese cabbage  
    • Dried figs  
    • Cooked greens  
    • Varieties of fish


Symptoms of Osteoporosis

One of the main issues with the onset of osteoporosis is that many people who begin developing it don´t realize they are afflicted until they experience a bone fracture as a result. That is one reason it´s important to take a proactive approach against osteoporosis.

Common symptoms of osteoporosis:

    • Loss of height as a result of weakened spine, Fractured bones, especially hip bones.
    • Bone pain and tenderness, Neck, spine, and lower back pain.
    • Broken bones, brittle fingernails, Periodontal disease, tooth loss.
    • Spinal deformities become evident like stooped posture, an outward curve at the top of the spine as a result of developing a vertebral collapse on the back.


Osteoporosis Risk Factors

Some people are more susceptible to osteoporosis than others. Some of the risk factors for osteoporosis are in the control of the individual, such as weight, while other risk factors can´t be controlled, such as family history of osteoporosis.


Uncontrollable Risk Factors of Osteoporosis

  • Age 

Osteoporosis becomes far more common as people age, especially once they surpass age 50.

  • Sex 

Osteoporosis is more common in women than men. About 80%, or four out of five, osteoporosis sufferers are women. Women going through menopause or post-menopausal are even more susceptible because of diminished amounts of hormones that are necessary for regenerating bone.

  • Family history

Research suggests that heredity and genetics play a major role in osteoporosis. Parents who have osteoporosis have children who have a greater chance of getting the disease.

  • Race and ethnicity

While osteoporosis affects all races and ethnicities, people who are Caucasian or of Asian or Latino descent are more likely to develop osteoporosis than those of African heritage.

  • History of broken bones 

People who have broken one or more bones during their adult years are at greater risk for osteoporosis. In fact, they may already have low bone density or osteoporosis.

  • Diseases and conditions

Here are some diseases and conditions that put a person with one or more of them at greater risk of developing osteoporosis: premature menopause, blood and bone marrow disorders, eating disorders, gastrectomy, gastrointestinal bypass procedures, multiple sclerosis, post-polio syndrome, rheumatoid arthritis, severe liver disease, spinal cord injuries, stroke, etc.


Controllable Risk Factors of Osteoporosis

  • Inactive lifestyle 

People who are bedridden, are inactive or do not exercise are at high risk of osteoporosis.

  • Smoking 

Smoking is bad for bones in many ways. For women, smoking can prevent estrogen from protecting the bones.

  • Alcohol Abuse 

Drinking heavily can reduce bone formation. In many cases, people who drink too much do much do not get enough calcium. Drinking may also affect the body’s calcium supply.

In addition, drinking too much is bad for a person´s overall health and can make you more likely to fall. Many people fall and break a hip or other bone when they are drunk. Alcohol in smaller amounts, however, does not harm bone health. This usually means no more than two drinks a day.


Osteoporosis Diagnosis

One of the only ways to determine if a person has osteoporosis is with a test called a bone density scan. It measures the amount of minerals in bones. This scan requires large machinery and must be conducted in a hospital or doctor´s office with the right equipment.

Bone density is measured on a point scale, called a “T” score. Normal bone density has a T score -1 or higher. If a person´s T score measures between -1 and -2.5, she will probably be diagnosed with osteopenia, a milder form of osteoporosis. A T score of less than -2.5 indicates osteoporosis.


Causes of Osteoporosis

Osteoporosis is inextricably linked to hormones. For this reason, women make up about 80% of osteoporosis sufferers, and a large percentage of those women have undergone menopause and the hormonal fluctuations associated with it. Estrogen is the predominant hormone that fades with the onset of menopause and puts women at a much higher risk of developing osteoporosis.


Estrogen and Osteoporosis

The graph to the right shows how drastically levels of estrogen drop off during menopause and post-menopause, beginning at about age 45. Estrogen levels in post-menopausal women are about one-tenth the amount present in pre-menopausal women. For this precise reason, women approaching menopause and those who have already gone through it are at a much higher risk of developing osteoporosis and suffering from bone fractures as a result.

Without adequate levels of estrogen, bones aren´t able to absorb the proper amounts of calcium to replenish bone mass as cells slough off and die. The body also has trouble controlling the amount of bone cells that are destroyed without estrogen to regulate the function.

Estrogen’s most important effect on osteoporosis appears to be prevention of bone breakdown, known as resorption.
Healthy bones require a balance of osteoclasts (cells that breakdown bones) and osteoblasts (cells that make new bone). As estrogen levels diminish, osteoclasts live longer than their counterparts, osteoblasts. This leads to bones being broken down at a rate much greater than they can be rebuilt, thus they grow weak and brittle.

Testosterone is the hormone responsible for bone strength and breakdown in men.


Other Causes

Researchers agree that the primary cause of osteoporosis in women as they surpass age 50 is diminished hormonal levels, particularly estrogen levels; however, there are other causes that need to be explored in order to have a comprehensive understanding of this serious bone disease.

Other causes of osteoporosis include the following:

    • Medications: some medications can reduce bones´ ability to rebuild themselves. Some of the medications that can cause osteoporosis are glucocorticoid medications, prednisolone, excess thyroid hormone replacement, the blood thinner heparin, and certain anti-convulsant medications.
    • Insufficient bone growth as a youth: Bones that didn´t get enough calcium early in life have a higher likelihood of becoming osteoporotic and fracturing as estrogen levels begin to decrease.
    • Genetic factors: If a woman´s family members, especially her mother, have suffered from osteoporosis, the likelihood that she will develop the disease jumps dramatically. Genetics also helps determine the body type of a woman. If she inherited a small, thin body type, she is predisposed to osteoporosis.


Osteoporosis Prevention

The best way to avoid the painful and debilitating bone fractures that come with osteoporosis is to prevent the disease before it takes hold. Of course going back in time to the teenage years when bone growth is most crucial is not a possibility. However, there are still ways to increase bone mass, or at least limit the rapid destruction of bones common in menopausal women, before osteoporosis becomes a problem.

Prevention tips for osteoporosis:

    • Eat enough calcium.
    • Make sure to get enough vitamin D.
    • Get adequate physical exercise.
    • Avoid alcohol.
    • Avoid smoking.
    • Maintain a healthy weight.


Staggering statistics:

A 10% loss of bone mass in the vertebrae can double the risk of vertebral fractures, and similarly, a 10% loss of bone mass in the hip can result in a 2.5 times greater risk of hip fracture.


Preventing Falls:

More than 90% of hip fractures are associated with osteoporosis. Nine out of 10 hip fractures in older Americans are the result of a fall. Individuals who have a hip fracture are 5 to 20% more likely to die in the first year following that injury than others in this age group. Most falls happen to women in their homes in the afternoon.

The above data shows how important it is to take care to avoid falling, especially after a certain age when osteoporosis is more common, namely after age 50 in women. Below is a list of tips to prevent falls:

Tips to prevent falls:

    • Wear appropriate, flat shoes.
    • Wear glasses with the correct prescription and have this checked regularly.
    • Avoid having loose rugs and carpets or trailing electrical flexes. Repair any torn floor coverings.
    • Make sure the home is well lit.
    • Be extra careful when taking medicines, especially sleeping pills and sedatives that may cause drowsiness, making a person more likely to trip or stumble.
    • Anyone who experiences dizziness or is at risk of falling should talk to their doctor about how their medications might affect this.
    • Anyone who needs to get up during the night to visit the toilet should consider using a chamber pot to avoid the risk of falling in the dark. Otherwise, leave some lights on where possible and make sure the route from the bed to the toilet is safe and clear of items that could cause a fall.


Treatments for Osteoporosis

When exploring treatments for osteoporosis, it´s important to begin with methods that are the least obtrusive, with the least likelihood of side effects, and progress from there.

This means that lifestyle changes are the best place to begin. Simple lifestyle changes that can reduce the likelihood of osteoporosis is eating a diet rich in calcium and exercising to build bone strength.

Typically, combining lifestyle changes and alternative medicines will produce the best treatment results. Alternative medicines can be different herbs and supplements, namely calcium supplements.

When seeking out alternative medicines, keep in mind that because osteoporosis during menopause is associated with hormonal imbalance, look for substances that bring a natural balance to hormonal levels, for this will go a long way to treating preventing osteoporosis at the core of the issue.


Treatment for Menopausal Symptoms:

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