09/17/2024
Menopause is a natural biological process that marks the end of a woman’s reproductive years, typically occurring between the ages of 45 and 55. While menopause brings about various changes in the body, one of the most significant and concerning effects is on bone health. The decline in estrogen levels during menopause can lead to a variety of changes in bone structure, density and overall strength, which can have long-term consequences for a woman’s skeletal system.
Learn more about menopause at Nuvance Health.
The Role of estrogen in bone health
Estrogen is a hormone that plays a crucial role in maintaining bone density. It helps to regulate the bone remodeling process, which is the ongoing replacement of old bone tissue with new bone tissue. During this process, bone cells called osteoclasts break down old bone, while osteoblasts build new bone. Estrogen helps to maintain a balance between these two activities, ensuring bone is broken down and replaced at a healthy rate.
When estrogen levels drop during menopause, this balance is disrupted. The decrease in estrogen leads to an increase in the activity of osteoclasts and a decrease in the activity of osteoblasts. This imbalance results in a net loss of bone mass.
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Bone loss and osteoporosis
One of the most serious consequences of menopause-related bone loss is the increased risk of osteoporosis, a condition characterized by weak and brittle bones. Osteoporosis makes bones more susceptible to fractures, even from minor falls or, in severe cases, from activities like bending over or coughing.
During the menopause transition, women can lose up to 20% of their bone density, making this period particularly critical for bone health. The most common sites for fractures due to osteoporosis are the hip, spine, and forearm/wrist. Hip fractures are especially concerning, as they often require surgery and can lead to long-term disability or even death in older women.
Learn more about osteoporosis and bone density scans at Nuvance Health.
Risk factors for menopausal bone loss
While all women experience some degree of bone loss during menopause, certain factors can increase the risk of more severe bone loss and osteoporosis. These include:
Genetics: A family history of osteoporosis or fractures can increase the risk.
Low body weight: Women with a lower body weight have less bone mass to begin with, which can increase the risk of osteoporosis.
Lifestyle factors: Smoking, excessive alcohol consumption and a sedentary lifestyle can all contribute to bone loss.
Diet: A diet low in calcium and vitamin D, which are essential for bone health, can accelerate bone loss.
Early menopause: An earlier onset of hormonal changes can affect bone density.
Related content: Your heart on menopause
Prevention and management
While menopause-related bone loss is inevitable to some extent, there are steps women can take to reduce their risk of osteoporosis and maintain bone health.
Calcium and vitamin D intake: Ensuring adequate intake of calcium and vitamin D is essential for maintaining bone density. Calcium-rich foods include dairy products, leafy green vegetables and fortified foods. Vitamin D can be obtained from sunlight exposure, fortified foods and supplements.
Exercise: Weight-bearing exercises, such as walking, jogging and strength training, can help to build and maintain bone density. These activities stimulate the bones to grow stronger in response to the physical stress they endure during exercise.
Lifestyle changes: Quitting smoking and limiting alcohol consumption can help protect bone health. Additionally, maintaining a healthy weight can reduce the risk of bone loss.
Medications: For women at high risk of osteoporosis, healthcare providers may prescribe medications to help slow bone loss and reduce the risk of fractures. Patients can discuss options with their providers based on the severity of osteoporosis and preference for how to take the medication.
Regular bone density tests: Women should discuss with their healthcare provider when to begin regular bone density screenings, which can help detect early signs of bone loss and guide treatment decisions.
Related Content: Navigating menopause
The bottom line: Menopause marks a significant transition in a woman’s life, with profound effects on bone health due to the decline in estrogen levels. Understanding the risks associated with bone loss during menopause and taking proactive steps to maintain bone density can help women protect their skeletal health and reduce the risk of osteoporosis and fractures. Through a combination of a healthy diet, regular exercise and, when necessary, medical intervention, women can take control of their bone health and enjoy a more active and healthy life after menopause.
Learn more about women’s health at Nuvance Health.
Dr. Mora is an endocrinologist and medical director of the Metabolic and Medical Weight Management Program for Nuvance Health East. She sees patients in Newtown and Wilton, CT. Learn more about Dr. Mora and/or schedule an appointment.