Studies suggest that half of women age 50 and older will break a bone due to osteoporosis, a condition in which bone density is significantly lower than normal. In postmenopausal women, fractures that result from osteoporosis are more common than stroke, heart attack, and breast cancer combined, and fractures can result in disability or death. Notably, the symptoms of osteoporosis may not be noticeable until a bone is fractured.
Estrogen is protective to bone by helping with calcium absorption, decreasing calcium loss in urine, and regulating mechanisms involved in bone turnover and density. With decreased estrogen levels after menopause, bone loss is about 2% per year, beginning 1 to 3 years before menopause and lasting for 5 to 10 years, resulting in an average loss of bone density of 10% to 12%. Thin women experience more bone loss than heavier women. After this interval of relatively rapid bone loss, bone density decreases to about 0.5% per year, but by age 80, women have lost approximately 30% of their peak bone mass.
Since most women don't notice bone loss until they experience a fracture, it's important to keep an eye out for signs. If you experience any of the following, see your doctor.
Back pain
Height loss
Stooped posture
Tooth loss
Weak or brittle nails
You can reduce your risk of bone loss and fractures by making a few lifestyle changes:
Maintain a healthy weight - being too thin or obese increases your risk.
Eat a balanced diet with adequate calcium and vitamin D - supplementing is not recommended unless you cannot get the amounts you need from food.
Participate in regular physical activity - put emphasis on improving balance and increasing strength with weight training to reduce fall risk.
Avoid excessive alcohol consumption (2 or more drinks per day).
Don't smoke.
Make sure you ask your doctor about your risk of osteoporosis. You'll want to mention if:
You've had any fractures after menopause.
Your mother had osteoporosis (or fractures after menopause.)
You take medications that cause bone loss (give a list of all medications and supplements to your doctor.)
You stopped taking estrogen.
You weigh less than 127 lbs.
You smoke currently.
You have 2 or more drinks of alcohol per day.
There are diagnostic tests like dual-energy x-ray absorptiometry (DXA) and vertebral imaging that your doctor can order if she deems necessary. Routine DXA screening is recommended for women over 65 and those at high risk for osteoporosis. Lab tests also can identify underlying conditions that may be contributing to bone loss. Drug therapy, including menopause hormone therapy (MHT), can prevent or treat bone loss in menopausal women. It has the biggest impact if started early so don't delay in talking to your doctor.
By making lifestyle changes and seeking medical attention as needed, women can maintain good bone health and reduce their risk of fractures.
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