At menopause, be on the alert for bone loss

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Although the vast majority of fragility fractures occur in women over the age of 65, the process of rapid bone loss which leads to osteoporosis and broken bones begins earlier, at the onset of menopause.

Almost everyone knows a woman who has suffered broken bones, or ‘fragility fractures’. In fact, worldwide, one in three women over the age of 50 will break a bone during their remaining lifetime. From the 55-year-old who has broken her wrist to the 80-year-old who has broken her hip, fractures due to osteoporosis exact a terrible toll on the quality of life of postmenopausal women worldwide.

Although the vast majority of fragility fractures occur in women over the age of 65, the process of rapid bone loss which leads to osteoporosis and broken bones begins earlier, at the onset of menopause. That’s when a woman starts to lose the protective effect of oestrogen.

Our bones undergo a natural process of formation and breakdown throughout life. When women become oestrogen deficient at menopause, bone breakdown begins to outpace bone formation – gradually leading to a decline in bone mass, and, in some women, to osteoporosis. Osteoporosis, which literally means porous bones, causes bones to become fragile and easily prone to fracture.

International Osteoporosis Foundation (IOF) President John A. Kanis, Emeritus Professor in Human Metabolism at University of Sheffield, says:

Menopause is a critical time to intensify preventive action that will help slow down the rapid increase in bone loss. It’s also a good point at which to do a ‘bone check’, to determine whether any specific factors are placing you at high-risk of future fractures.”

Certain factors place both men and women at higher risk of osteoporosis and fractures. These include, among others, age, a family history of osteoporosis, smoking, excessive alcohol use, being underweight, rheumatoid arthritis, corticosteroid use, and disorders such as celiac or Crohn’s disease. And, ironically, sustaining one fracture is among the strongest indicators of future fracture risk. Kanis adds:

Worldwide, osteoporosis causes more than 8.9 million fractures annually, resulting in an osteoporotic fracture every 3 seconds.Unfortunately, as many as 80 per cent of fracture patients are not being properly diagnosed and treated for osteoporosis, the underlying cause of the fracture. As a result many will go on to suffer a cascade of broken bones which lead to hospitalizations and disability — it's devastating not only for the patients but their families too.”

IOF recommends that postmenopausal woman follow these five essential steps for early prevention:

  • Exercise for at least 30 to 40 minutes, three to four times each week, with some weight-bearing and resistance exercises in the programme
  • Ensure adequate intake of bone-healthy nutrients. Eat a diet rich in calcium, protein and other essential vitamins and minerals (and keep in mind that vitamin D is produced in the body via safe exposure to sunlight). Recommendations for calcium intake in postmenopausal women range from 700 mg (UK) to 1200 mg (USA).
  • Avoid negative life-style habits such as smoking and excessive drinking, and maintain a healthy body weight with BMI not below 20 kg/m2.
  • Identify your personal risk factors. The IOF One-Minute Osteoporosis Risk Test will help you identify any specific risks.
  • Talk to your doctor about bone health at your next check-up and ask for testing, which often begins with a FRAX assessment of your 10-year risk of fracture. If indicated, your doctor will refer you for further testing and possibly treatment should it be required.

Take action today to help maintain strong bones and muscles as you age.

LYB logoThis article appeared in our monthly Love Your Bones newsletter sent to IOF members.

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