Bone Health During Menopause: A Guide to Preventing Osteoporosis

Understanding the Link Between Menopause And Bone Health

Are you wondering how menopause affects your bone health? Join me as we delve deep into the topic. 

How Menopause Affects Bone Density? 

Ovaries are the glands that produce oestrogen throughout a woman’s life. Oestrogen is an essential hormone that maintains bone health and density. It also regulates the balance between bone resorption (breakdown) and bone formation.

As women reach menopause age, the ovaries produce less oestrogen. As a result, the oestrogen levels decrease in the body. The effects of oestrogen decline are,

• The calcium absorption in the intestines reduces.
• The harmony of bone remodelling is affected, and bone resorption becomes faster when compared to bone formation.

These changes lead to a decrease in bone mass and density, causing an increased risk of fractures and osteoporosis.

What is Osteoporosis?

‘Osteo’ means ‘bone’; ‘Porosis’ means ‘porous (full of holes)’ - It literally means the bones

full of holes. It forms holes in the inner part of the bone, similar to a sponge, making it weak and fragile.

It is also called a “silent” disease, as it typically progresses with no noticeable symptoms. 

Women with osteoporosis may not experience pain or may experience some discomfort, with the condition often going unnoticed until a fracture occurs. 

Osteoporosis occurs due to the reduced bone mass and structural deterioration of bone tissues. Oestrogen is the natural protector and defender of bone strength. Due to the rapid decrease in oestrogen, postmenopausal women are at higher risk of osteoporosis. Common sites of fractures due to osteoporosis include the spine, hips and wrists. 

Women are more prone to osteoporosis than men. Osteoporosis in women begins in the early 50s while in men in the 70s.

Change in Bone Density as Women Ages

In the perimenopausal period (about 5-7 years), a woman loses about 1.8-2.3% of bone mass in the lumbar spine and 1.0-1.4% in the hip annually. This loss of bone mass and density over time makes the bones fragile and thin, leading to osteoporosis.

Symptoms of Osteoporosis

Even though osteoporosis develops without any noticeable symptoms and is diagnosed after a fracture occurs, some women might experience the following,

• Chronic back pain
• Gradual decrease in height 
• Stooped or hunched back

Risk Factors for Osteoporosis During Menopause

It is not just the decreased oestrogen levels that weaken the bones.

There are several factors that increase the risk of osteoporosis in menopausal and postmenopausal women. 

It is the combination of these factors and reduced oestrogen levels during menopause that leads to osteoporosis.

• Age: Bone density decreases as you age. Up to 30 years of age, the body forms bone more than loss. However, as age increases, the rate of bone loss is quicker, and bone growth is slower. During menopause, the process of bone loss accelerates due to decreased oestrogen.
• Sex: Women have a higher chance of developing osteoporosis than men. Women have lower peak bone mass and smaller bones when compared to men.
• Body Size: Women with thin and slim bodies are more likely to develop osteoporosis than larger-boned women. This is because women with petite bodies have fewer bones to lose than the ones with larger body frames.
• Genetics: If your family members, parents or grandparents had osteoporosis or a fractured hip, you might be at a greater risk of developing osteoporosis.
• Race: White and Asian women are at higher risk of developing osteoporosis when compared to African-American and Mexican-American women. 
• Existing Bone Density: When you are young, it is your responsibility to build strong bones and save up the bone mass. If your bone mass and density are higher at the beginning of menopause, you will run out of it less quickly and develop osteoporosis.
• Lifestyle Choices: Habits of smoking, excessive consumption of alcohol or a sedentary lifestyle can contribute to the loss of bone mass
• Diet: Critical age of bone development is between ages 9-18. It is necessary to consume a diet rich in calcium and vitamin D to support healthy bone development during this period. A reduced intake of food with calcium and vitamin D or dieting reduces bone health and increases the risk of osteoporosis.
• Medical Conditions: Medical conditions such as rheumatoid arthritis, AIDS, cancers, gastrointestinal disorders and anorexia nervosa can increase the risk of osteoporosis.
• Medications: Long-term use of certain medications such as antacids, antiepileptics, and others makes you more prone to develop bone loss and osteoporosis.

Preventive Measures for Maintaining Bone Health During Menopause

No need to worry, ladies - there are plenty of ways to boost your bone health.

1. Increased Calcium Intake

Calcium is the mainstay for bone health. It is extremely necessary to meet the daily requirements of calcium.

The recommended daily allowance (RDA) of calcium for a woman between ages 19-50 is 1000mg, and 51-70 is 1200mg. 

Are you curious about how to meet your recommended daily intake of calcium? It’s simple. Here are some foods that are rich in calcium to include in your diet - milk, cheese, yoghurt, kale, spinach, and plant-based milk.

2. Vitamin D and Bone Health 

Vitamin D helps your intestines absorb more calcium. This helps improve bone health. It ensures the calcium you consume is properly absorbed and utilised to maintain your bone.

The recommended daily allowance (RDA) of vitamin D for a woman between ages 19-70 is 600 IU. This may vary according to skin type and sun exposure. 

Sun is the primary source of vitamin D; it helps in the synthesis of vitamin D in the body.

Try to include foods such as salmon, cereals and fortified foods (rich in vitamins D and A) in your diet.

3. Physical Activity and Weighting-Bearing Exercise

Exercise and physical activity might seem tiring or dull, but do you know they help strengthen your bones?

Start small and stay consistent - begin a 15-20-minute walk daily. On some days, mix it up with jogging or running. 

Strength training with weights or resistance bands helps improve your bone strength.

Did you know dancing also improves bone health? Damn yeah! If you love to dance or want to dance, you can also include dancing in your routine.

Click here to learn more about menopause fitness and exercise routine.

4. Lifestyle Modifications

Quitting smoking, alcohol, and caffeine helps improve bone health.

Smoking reduces the body’s ability to produce oestrogen and, therefore, reduces bone health.

Alcohol and caffeine, when consumed in excess, lead to reduced absorption of calcium in the body.

5. Maintaining a Healthy Weight

Being underweight or overweight has a negative impact on your bone health. 

Underweight is an example of your body being deprived of nutrition. Less nutrition leads to improper bone health, causing osteoporosis.

Being overweight leads to excess pressure on the weight-bearing joints such as the knees, hips or lower back. This causes the deterioration of bones at an earlier age. This increases the risk of osteoporosis in women during menopause.

Monitoring Bone Health

It is physically not possible to determine the bone density. Therefore, a diagnostic tool is used to determine it.

Bone Density Test (DEXA Scan)

• A dual-energy x-ray absorptiometry (DEXA) scan is a diagnostic tool for measuring bone density. 
• It helps identify the early signs of bone loss and determines the risk of fractures.
• It also guides doctors in making treatment decisions for osteoporosis and maintaining bone health. 

Medical Interventions for Bone Health

Certain medications help improve bone health; for menopausal women who are at a higher risk of fractures or osteoporosis, medical treatment may be necessary.

• Bisphosphonates: These medications slow down the process of bone resorption and help maintain bone density.
• Hormone Replacement Therapy (HRT): Oestrogen-only therapy (tablets or capsules) improves the levels of oestrogen in the body, improving bone mass.

To learn more about HRT, click here.

• Selective Oestrogen Receptor Modulators: These medications replicate only the bone-protective function of oestrogen without displaying its other effects.
• Supplements: Calcium and vitamin D supplements provide essential nutrients that are required for bone health.

When to See Your Doctor?

Making a decision about when to see a doctor can sometimes be puzzling. However, there are certain situations when you should seek your doctor’s advice.

• Risk Assessment: Consult a doctor if you have risk factors such as family history of osteoporosis, lifestyle habits that increase bone loss or medical conditions that can lead to bone loss.
• Persistent Symptoms: Back pain, reduced height or fractures due to minor injuries are a warning sign for a medical evaluation.
• Preventive Screening: It is recommended that women over 50 have regular bone density tests and blood work for calcium and vitamin D at least once a year.

Tips for Long-Term Bone Health

Health is wealth. Bone health is a vital component of overall well-being, especially during menopause. 

Here are some tips that will help you maintain your bone health.

• Consistency is Key: Anything that comes easily goes away easily. The same applies to your health. For long-term benefits, you need to have a long-term approach. To improve bone health, maintain regular exercising, a balanced diet and healthy habits.
• Stay Informed: Keep yourself updated with the latest trends, research works and medical advancements in bone health and osteoporosis prevention.
• Build a Support System: Collaborate with healthcare professionals to tailor a personalised plan to maintain bone health and prevent osteoporosis.

Final Thoughts 

Strong and healthy bones are vital for your well-being. They help you age gracefully. 

It is essential to prioritise bone health through good nutrition, a balanced diet, and healthy habits.

Ladies, don’t wait! It’s time to groove with menopause and bid goodbye to osteoporosis with Nirva Health, where our Ayurveda and Yoga experts join forces to create tailored treatment, personalised diet plans and one-on-one yoga sessions.