You know about hot flashes, vaginal dryness, and the potential for weight gain. But there’s another menopausal symptom to add to the list: bone loss.
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Bone loss occurs when your bones deteriorate faster than they can grow and strengthen themselves — and up to 20% of bone loss occurs within the first five years of menopause.
But what is the big problem with bone loss?
It greatly increases the risk of bone fractures and can lead to osteoporosis (low bone mineral density) and osteoporosis (weakened bones). “Adults should not break a bone when they fall from a standing position,” says women’s health specialist Holly L. Thacker, MD, FACP. “This is not a standard part of aging.”
Bone fractures can lead to a host of other health problems as well, so taking care of your bones is a key aspect of taking care of your health in menopause. Dr. Thacker discusses what you need to know about menopause, bone loss, osteoporosis, and more.
Does menopause lead to osteoporosis?
Your bones live, tissue that constantly remodels itself grows, and when you’re young, it rebuilds quickly. Starting in your 30s, bone loss is normal. Your bones cannot rebuild themselves as quickly as they used to, causing a loss of bone mass.
This is thanks to estrogen – or, indeed, a lack of it. Estrogen regulates the menstrual cycle and protects you from bone loss. But as you enter menopause, your body slows down the production of estrogen, which leads to bone loss.
“When you don’t have enough estrogen, bone breaks down much faster than it accumulates, and therefore, there is a net loss,” Dr. Thacker explains.
Is early menopause a risk factor for osteoporosis?
Menopause leads to bone loss, PMS. So, no matter when it happens, you are at risk when it does. “Throughout menopause, women should be screened for osteoporosis,” advises Dr. Thacker.
But typical menopause occurs between the ages of 45 and 55, so if you go into menopause earlier than that, you’re also at risk of losing bone at an earlier age than usual. It includes:
- Early menopause (before age 40).
- Early menopause (before age 45).
- Primary ovarian insufficiency (POI), formerly known as ‘primary ovarian failure’.
- Medical menopause, whether the result of surgery or the result of medical treatment, such as chemotherapy.
How do you keep your bones healthy during menopause?
Once menopause reveals its presence, it’s time to speak with your doctor.
“It is essential to discuss and develop a bone loss prevention plan with your doctor when the first signs of menopause appear,” says Dr. Thacker. “It’s a great time to take a basic bone density test and review your family history, lifestyle, medications, and what you can do to be strong and healthy.”
She explains some of the options for ensuring bone health during this time in your life.
1. Healthy lifestyle
Perhaps not surprisingly, the same things that doctors recommend for living a healthy life in general also help keep your bones healthy. This includes:
- Exercising regularly, including weight-bearing exercises.
- Eat healthy and get enough calcium and vitamin D.
- Avoid tobacco and moderate alcohol consumption.
But this may not be enough to stave off bone loss.
“If you’re losing your bones fast, not all the exercise, milk, and vitamin D in the world will stop that,” she says. “Many women, especially those who have had a broken bone or have a lot of risk factors, need prescription treatment. We have many different safe and effective options to prevent bone loss, build bone and reduce your likelihood of breaking a bone.”
2. Hormone replacement therapy
Hormone replacement therapy (HT) is the gold standard in treating menopause, including bone loss. why? Because it targets everyone of your symptoms. HT is usually the first and best course of action because it helps prevent bone loss And It treats some of the annoying symptoms of menopause, such as hot flashes and vaginal dryness.
“If you have menopausal symptoms, hormone therapy can improve your bone health while also treating your symptoms,” notes Dr. Thacker. “It’s all about finding the right dose and the right route for every woman.”
There are different cycles of HT for menopause, and what works for you will depend on your unique medical situation – for example, whether you are in early or early menopause, no longer have a uterus or are already postmenopausal.
There is no time limit on how long you can be on HT, although it only helps your bones while you’re taking it. And 5% to 15% of women still lose bone density due to HT, so it’s important that you continue to be monitored by your doctor.
If you can’t or don’t want to be on HT for any reason, or if you’re on HT but are still losing bone, your doctor may prescribe a bisphosphonate. These medications are designed to slow bone loss.
They can also help prevent bone loss if you take glucocorticoids (steroid hormones that treat inflammation, autoimmune disease, and cancer). “Hormonal therapy alone will not protect you from glucocorticoid-induced osteoporosis, so bisphosphonates offer a preventative treatment for bone loss,” says Dr. Thacker.
4. Injectable medicines
If you have severe osteoporosis, your doctor may consider using anabolic medications that build bone. There are currently three approved options on the market, and your doctor will determine which one is right for you.
Management of postmenopausal osteoporosis
You may think that you are not at risk of bone loss because you are feeling better. No joint pain, no broken bones, so problems, right? not exactly.
“There are no symptoms of osteoporosis until it is broken,” warns Dr. Thacker. “That’s why you really have to be vigilant, and that’s why your doctor will want to know your family history, bone density and hormone levels.”
In other words, don’t make any bones about it: If you’re going through menopause or starting to have symptoms, it’s time to talk to your doctor about preventing osteoporosis and osteoporosis. Your bones will thank you for it!