Osteoporosis and Menopause

image depicting bone with osteoporosis

Bone with Osteoporosis

Osteoporosis occurs more rapidly in women than men particularly when estrogen and progesterone levels decline, effectively speeding up bone loss. This is a serious symptom of menopause as it can lead to severe health problems such as chronic back pain and broken bones.

During perimenopause (the transitional phase before actual menopause takes places which is marked as your final menstruation) you will begin not to ovulate during some menstrual cycles and your progesterone levels drop. As a result of this your bones loss begins to worsen. Once your ovaries stop functioning totally (after the final menstruation) or are removed during a hysterectomy, they stop producing the important hormone progesterone and estrogen levels decline.

After menopause bone resorption (breakdown) outpaces the building of new bone. Early menopause – before the age of 45 – and any prolonged periods in which hormone levels are low and menstrual periods are either absent or infrequent can cause loss of bone mass.

What is Osteoporosis?

Osteoporosis literally means porous bone and is often called the silent disease – it is the loss of bone density and thinning of bone tissue. Many people don’t know that they have osteoporosis until their bones become so weak that a sudden fall or other incident causes a fracture or a vertebrae to collapse.

Bone loss should be at its optimum in our late 20s and early 30s, however, due to poor diet and lack of exercise, many women start losing bone mass in their 20s. After age 35 bone breakdown overtakes bone building.

Osteoporosis is a progressive degenerative bone disease where women and men experience bone loss and decreasing bone density, causing all the bones in their body to become spongy, porous and lighter. You are more at risk of bone fractures which can be very painful and debilitating.

Symptoms of Osteoporosis

Although osteoporosis can progress without symptoms, some early signs of osteoporosis are:-

  • Hunched shoulders
  • Lower back pain
  • Gradual loss of height
  • Increasing amount of frailty
  • Compression fractures in the vertebrae. These can cause a number of related health problems and can be extremely painful as nerves in the spine can be affected
  • Tooth loss or loose teeth – due to a weaker jaw bone structure associated with decreased bone density
  • Gum disease
  • Sudden sleep disturbances and restlessness
  • Leg and foot cramps

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You are at Risk of Osteoporosis if…

  • If you are a thin, small boned. You are more at risk of developing osteoporosis as you will have less bone to lose than women with larger frames and more body weight
  • If your calcium intake is low
  • If you eat too much animal protein
  • If you don’t exercise, are physically inactive (lead a sedentary lifestyle)
  • If you smoke – your body will absorb less calcium from your diet
  • If you drink alcohol excessively – 2/3 units per day can be damaging to your health. There is tenuous evidence that moderate alcohol consumption puts the scale of the formation and resorption processes back in the right direction. The emphasis being on ‘moderate’ consumption.
  • If you reached menopause before the age of 45
  • If you have had a hysterectomy and your ovaries were removed
  • If you have an overactive thyroid or kidney disease
  • If you have eating disorders such as anorexia or bulimia
  • If you are over 50 you are more at risk of developing osteoporosis and 4 x more likely than a man
  • If you are a Caucasian or Asian woman you are more likely to develop osteoporosis
  • If your grandmother or mother has Osteoporosis you are more at risk of developing it. Family history/hereditary is one of the most important risk factors

Osteoporosis Prevention

Calcium and Vitamin D supplements can be used to prevent bone loss when dietary intake is low.

Update:

Calcium Supplementation:  Until recently, women over 50 were recommended to take at least 1000-1500mg/day to prevent fractures. Many women used to take calcium supplements to help increase their intake. However, recent trials have raised some concern over the safety of supplements. Currently, there is little evidence to show that increasing your calcium intake above 800mg (either in additional calcium food sources or supplements) prevent fractures. Taking a supplement of 1000mg daily is associated with an increased risk of heart attack, kidney stones, constipation and gastrointestinal problems. If you have been taking calcium supplementation for some time, it is time to review your intake with your healthcare professional. New studies suggest that we should reconsider and revise our approach. Your healthcare professional may still advise you that you need a total intake (dietary and supplementary) of 1000-1500mg/day, so he/she may suggest a daily calcium supplement of 500mg together with calcium-rich foods. Supplements containing both calcium and vitamin D3 seem to have the safest profile.

Vitamin D Supplementation: Current evidence is strong in support of women over 50 supplementing with vitamin D3 to prevent fractures and falls. There are 2 forms of vitamin D used in supplements.

  • Vitamin D2 (ergocalciferol)
  • Vitamin D3 (cholecalciferol)

Vitamin D3 is the preferred one as chemically it has more similarities to the form of vitamin D produced by the body and is more effective than vitamin D2 at raising the blood levels of vitamin D.

Exposure to sunlight helps to increase bone mass (don’t forget the associated health risks related to too much sun exposure – 20 minutes per day is fine – 3 hours baking in high temperatures is not!)

Avoid or moderate your consumption of caffeine. Caffeine is known to increase the level of homocysteine in the body which increases the risk of osteoporosis

Take a high grade multivitamin supplement to improve your energy levels and vitality. This will also aid better sleep, improve your immune system and aid the health of your heart and circulation

Take a daily Omega 3-fatty acids supplement to treat osteoporosis symptoms. Known to improve arthritis symptoms, reduce inflammation and the risk of heart attack and stroke

Exercise is very important to bone building in both men and women. Examples of weight bearing exercise are Walking, weightlifting, tennis, swimming, resistance exercise i.e. stationary cycling, tai chi, yoga, tread mills and so on

Food sources to top up your calcium levels include: canned fish including their soft bones (particularly tuna and salmon), green vegetables (spinach broccoli and kale provide some calcium) breakfast cereals, tofu, full fat milk, low fat cheese, cottage cheese, brazil nuts, tofu, yoghurt

Consume the recommended 8-10 glasses of water each day, preferably filtered water

You may find the article about menopause supplementation beneficial.

Osteoporosis Treatments

HRT is no longer routinely recommended solely for the purpose of preventing osteoporosis due to the associated risks, however, HRT is often prescribed for women who may have:-
• Multiple risk factors for osteoporosis i.e. family history, slight build
• Experienced early menopause – before age 45
• Low bone density based on testing

NHS UK has a list of current prescription medication for the treatment of osteoporosis.

Calcium should be given in addition to osteoporosis treatment if aged over 70 or if aged under 70 and dietary insufficient.

A painless and accurate test called a Bone Density Test can provide information about your bone health.

You should have this test if you are:-

  • Postmenopausal and have suffered a fracture
  • Under 65 and have one or more additional key risk factors (outlined above)
  • If you are postmenopausal age 65 and over.

Useful links:
Here you will find more information about Osteoporosis

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Sources:

Osteoporosis Fact Sheet (2012) Retrieved from https://www.womenshealth.gov/publications/our-publications/fact-sheet/osteoporosis.html [epublication]

Osteoporosis Treatment. Retrieved from http://www.nhs.uk/Conditions/osteoporosis/Pages/treatment.aspx
Causes of osteoporosis. Retrieved from http://www.nhs.uk/Conditions/Osteoporosis/Pages/Causes.aspx
Osteoporosis & Menopause. Retrieved on 2 July 2014. Retrieved from http://my.clevelandclinic.org/health/diseases_conditions/hic-what-is-perimenopause-menopause-postmenopause/hic_Menopause_and_Osteoporosis
Osteoporosis and Menopause. Retrieved on 2 July 2014. Retrieved from http://www.webmd.com/menopause/osteoporosis-menopause
Sampson, H, Wayne, Ph.D. Alcohol and Other Factors Affecting Osteoporosis Risk In in Women Retrieved from http://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm

Page Last Updated on April 25, 2016