What’s happening
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.
What helps
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)
When to see someone
Diagnosed based on BMD measurement (T-score ≤ -2.5) or history of fragility fracture.