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Osteoporosis Risk / Bone Loss (Menopause-Related Consequence)

Menopause significantly increases a woman's risk for osteoporosis, a condition where bones become weak and brittle, leading to increased fracture risk. Estrogen plays a crucial role in maintaining bone density. The rapid decline in estrogen during menopause accelerates bone loss. This loss is often 'silent' until a fracture occurs. Prevention and management involve adequate calcium and vitamin D intake, weight-bearing exercise, avoiding smoking and excessive alcohol, and bone density screening (DEXA scan). Medications are available to treat osteoporosis.

MusculoskeletalBone HealthLongTerm Consequence

Management Strategies

screening:
  • Bone Mineral Density (BMD) testing (DEXA scan) recommended for women 65+, or earlier based on risk factors (e.g., postmenopausal <65 with risk factors, fracture after 50).
medications:
  • Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid)
  • Denosumab (Prolia)
  • Raloxifene (SERM)
  • Teriparatide/Abaloparatide (anabolic agents)
  • Romosozumab (anabolic agent)
  • Hormone Replacement Therapy (HRT) - prevents bone loss but used based on overall risk/benefit profile
prevention lifestyle:
  • Adequate calcium intake (diet/supplements - ~1200mg/day for postmenopausal women)
  • Adequate vitamin D intake (diet/supplements/sun exposure - ~800-1000 IU/day or more, check levels)
  • Regular weight-bearing and muscle-strengthening exercise
  • Fall prevention strategies
  • Avoiding smoking
  • Limiting alcohol consumption

Impact

  • Fractures (leading to pain, disability, loss of independence)
  • Height loss
  • Stooped posture (kyphosis)

Diagnostic Considerations

Diagnosed based on BMD measurement (T-score ≤ -2.5) or history of fragility fracture.