Osteoporosis and Bone Health

Osteoporosis is a disease women often worry about as they get older. However, what many may not know is the role menopause can play in developing or advancing existing osteoporosis.

Osteoporosis and Menopause

Osteoporosis is a disease that causes thin bone tissue and reduces bone density. The result is weak bones that are more susceptible to fracture. Because osteoporosis shows very few symptoms and can progress to advanced stages without presenting any problems, it’s often not discovered until the weakened bones fracture and break. Once you have one fracture as a result of osteoporosis, you’re more susceptible to another.

These breaks and fractures can be debilitating. Most often, the weakened bones aren’t discovered until after a catastrophic fall that results in a broken hip or back. These injuries can leave you with limited or no mobility for several weeks or months.

The cause of osteoporosis is unknown. What is known, however, is how the disease develops and what it does to bones. Think of your bones as living, growing, and ever-changing entities of your body. Now, imagine the outer parts of the bone to be cases. Inside the case is a more delicate, hole-filled bone, similar to a sponge. As you develop osteoporosis and your muscles begin to weaken, the holes in the inner portion of the bone grow larger and more numerous. This means the internal structure of the bone is weakening and crumbling. If you fall when your bones are in this state, they won’t be strong enough to sustain the fall, and they’ll break or fracture. 

Understanding The Risk

Estrogen acts as a natural protector and defender of bone strength. As women near and then begin menopause, estrogen levels begin to fall. This lack of estrogen contributes to the development of osteoporosis, as bones are getting less help from the body’s hormones to stay strong. However, decreased estrogen levels are not the only cause for osteoporosis. Other factors may be responsible for weakened bones and when combined with the decreased estrogen of menopause, the development of osteoporosis may begin or speed up if it’s already present in your bones.

The following are also risk factors for osteoporosis:

Age

Before age 30, your body normally creates more bone than you lose. After that, bone deterioration occurs more rapidly than bone creation. The net effect is a gradual loss of bone mass.

Body Composition

Women who are petite or thin have a greater risk of developing osteoporosis compared to women who are heavier or have a larger frame. That’s because thinner women have less bone to lose compared to larger women. The same is true for men: thin men are at a greater risk for developing osteoporosis compared to men with more body weight or larger frames.

Existing Bone Density

When you reach menopause, the greater your bone density, the lower your chance of developing osteoporosis is. Think of your body as a bank: you spend your whole life building or “saving up” bone mass. The more bone mass you have to lose at the start of menopause, the less quickly you’ll “run out.” That’s why it’s important to encourage your daughters and other women to actively build bone density in their younger years.

Family History

If your parents or grandparents were diagnosed with osteoporosis or suffered a fractured hip as a result of a minor fall, you may be at a greater risk for developing osteoporosis.

Gender

Women are four times more likely to develop osteoporosis than men. Women over the age of 50 have the greatest risk for developing the bone disease. That’s because women tend to be smaller—they usually weigh less and have smaller bones compared to men.

Race

Caucasian and Asian women have a greater chance of developing osteoporosis. In addition, Caucasian women are twice as likely to suffer a hip fracture as the result of a fall when compared to black women.

Treatment Options

Treatment options to stop the progression of osteoporosis exist, and there are steps you can take to prevent bone deterioration in the first place.

Take calcium and vitamin D supplements.

Calcium can help build strong bones and keep them strong as you age. The National Institutes of Health (NIH) recommends that people ages 19 to 50 get 1,000 milligrams of calcium each day, or 400 international units (IU). People over 50—especially women—should get at least 1,200 milligrams of calcium each day (400 to 800 IU). If you can’t get adequate calcium through food sources like dairy foods, talk with your doctor about supplements. Both calcium carbonate and calcium citrate deliver good forms of calcium to your body.

Vitamin D is important for healthy bones, as your body can’t properly absorb calcium without vitamin D. The average person produces all the vitamin D they need in a day just by being in the sun for 20 minutes. However, for people concerned with skin cancer or those who wish to get their vitamin D in other ways, supplements are available. People over age 50 should get at least 600 IU  of vitamin D each day. 

Ask your doctor about prescription medications and injectable bone-building agents.

A group of drugs called bisphosphonates help prevent bone loss. Over time, these medicines have been shown to slow bone loss, increase bone density, and help reduce the risk of bone fractures in the event of a fall. Selective estrogen receptor modulators (SERMs), a group of drugs that have estrogen-like properties, are sometimes used for the prevention and treatment of osteoporosis. SERMs also have been shown to reduce the rate of fracture as a result of falls by up to 50 percent.

Make weight-bearing exercise part of your fitness routine.

Exercise often does more for building and maintaining strong bones than medication does. Exercise makes bones stronger, helps prevent bone loss, and also speeds up recovery in the event of a bone fracture. Walking, jogging, dancing, and aerobics are all good forms of weight-bearing exercise.

Talk to your doctor about hormone therapy.

Hormone therapy isn’t for everyone, but it’s a treatment option that you and your doctor can discuss. Hormone therapy can help prevent bone loss as a result of decreased estrogen during perimenopause and menopause. (Consequently, hormone therapy also treats some of the other symptoms of menopause, including hot flashes, night sweats, and mood swings.) If you have a personal history of or are at increased risk for heart attack, stroke, blood clots, or breast cancer, hormone therapy may not be the correct treatment option for you.