Menopause & Osteoporosis
There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. Fortunately, there are steps you can take to prevent osteoporosis, and treatments are available to slow the rate of bone loss if you have osteoporosis.
What is osteoporosis?
Osteoporosis is a disease that weakens bones, increasing the risk of sudden and unexpected fractures. Literally meaning "porous bone," it results in an increased loss of bone mass and strength. The disease often progresses without any symptoms or pain. Generally, osteoporosis is not discovered until weakened bones cause painful fractures (bone breakage), often in the back (causing chronic back pain) or hips. Unfortunately, once you have an osteoporotic fracture, you are at high risk of having another. These fractures can be debilitating. Fortunately, there are steps you can take to prevent osteoporosis from ever occurring. Treatments can also slow the rate of bone loss if you have osteoporosis.
What causes osteoporosis?
Though we do not know the exact cause of osteoporosis, we do know how the disease develops. Your bones are made of living, growing tissue. An outer shell of cortical or dense bone wraps trabecular bone, a sponge-like bone. When a bone is weakened by osteoporosis, the "holes" in the "sponge" grow larger and more numerous, weakening the inside of the bone.
Until about age 30, a person normally builds more bone than he or she loses. After age 35, bone breakdown overtakes bone buildup, which causes a gradual loss of bone mass. Once this loss of bone reaches a certain point, a person has osteoporosis.
How is osteoporosis related to menopause?
There is a direct relationship between the lack of estrogen after menopause and the development of osteoporosis. After menopause, bone resorption (breakdown) overtakes the building of new bone. Early menopause (before age 45) and any long phases in which the woman has low hormone levels and no or infrequent menstrual periods can cause loss of bone mass.
What are the symptoms of osteoporosis?
Osteoporosis is often called the "silent disease" because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump, or fall causes a fracture or a vertebra to collapse. Collapsed vertebrae may be first noticed when the person suffers severe back pain, loss of height, or spinal deformities such as stooped posture.
Who gets osteoporosis?
Important risk factors for osteoporosis include:
Age. After maximum bone density and strength is reached (generally around age 30), bone mass begins to naturally drop with age.
Gender. Women over the age of 50 have the greatest risk of developing osteoporosis. In fact, women are four times more likely than men to develop osteoporosis. Women’s lighter, thinner bones and longer life spans are some of the reasons why they are at high risk for osteoporosis
Race. Research has shown that Caucasian and Asian women are more likely to develop osteoporosis. Additionally, hip fractures are twice as likely to occur in Caucasian women as in black women. However, women of color are more likely to die after a hip fracture
Bone structure and body weight. Petite and thin women have a greater risk of developing osteoporosis because they have less bone to lose than women with more body weight and larger frames. Similarly, small-boned, thin men are at greater risk than men with larger frames and more body weight
Family history. Heredity is one of the most important risk factors for osteoporosis. If your parents or grandparents have had any signs of osteoporosis, such as a fractured hip after a minor fall, you may be at greater risk of developing the disease
How can I know if I have osteoporosis?
A painless and accurate test can provide information about your bone health before problems begin. Bone mineral density (BMD) tests, or bone measurements, are X-rays that use very small amounts of radiation to determine bone density. In addition to measuring bone health, the test can determine how severe any osteoporosis is.
Please note that women with no other risk factors whose BMD T-scores are below -2.5 should begin treatment to reduce the risk of fractures. (T-scores compare a person’s BMD to the optimal, or best, density of a healthy 30-year-old woman to determine the risk of fracture.) Women with BMD T-scores below -1.1 and who have other risk factors should also consider beginning treatment to reduce the risk of fractures. Your doctor will talk to you about your own risks for fracture to determine if you need medication.
Who should have a bone mineral density test?
All post-menopausal women who suffer a fracture that is suspicious for osteoporosis.
All post-menopausal women under age 65 who have one or more additional risk factors.
All post-menopausal women age 65 and over, regardless of additional risk factors.