Driven by the age-related decline of reproductive hormone levels, menopause marks the end of female menstruation and fertility. It also marks the end of living with the protective effects of estrogen — and the start of living with a higher risk of developing osteoporosis.
Menopause is a major cause of bone loss in aging women, but there’s a lot you can do before you reach “the change of life” to build stronger bones and keep osteoporosis at bay.
May is Osteoporosis Awareness and Prevention Month. For Dr. Rania Ibrahim and our women’s wellness team at New Beginnings OB/GYN, it’s an ideal time to shine a spotlight on bone loss after menopause — and what you can do to minimize it.
Bone tissue is in a continuous state of growth, resorption, and renewal. It becomes stronger and denser during adolescence; up to 60% of an adult's bone mass is formed during puberty.
Bones continue getting stronger and denser until they reach peak bone mass (PBM) — or the maximal amount of strength and density they can attain within your lifetime — by your early twenties. Your PBM level is influenced by:
PBM is also highly influenced by gender: Women tend to reach PBM earlier than men — meaning they have less time to build bone density — and they also tend to have smaller frames, thinner bones, and lower PBM levels compared to men.
After reaching peak mass, bone density maintains a consistent “plateau” level until middle age. After age 50, bone resorption begins to outpace bone formation, resulting in a gradual — but not critical — decline in bone mass.
Your PBM essentially acts as a “bone bank” for the future: The higher your PBM, the lower your risk of osteopenia (lower than average bone density) and osteoporosis (accelerated loss of bone density and mass; bone weakness and fragility) after middle age.
Everyone loses some bone density with age. Unfortunately, several factors can actively accelerate bone loss and degenerative changes in bone structure, increasing the likelihood of osteoporosis. These include:
While younger adults can experience accelerated bone loss, leading to osteoporosis risk factors, it forms a two-sided coin with older age on one side and female gender on the other.
Because women have more compact bones with a thinner cortex and smaller diameter — and because their PBM is often lower — they’re inherently more likely to get osteoporosis. In fact, four in five (80%) osteoporosis cases are diagnosed in women.
Getting older does increase the risk of osteoporosis for men and women alike, but women have a unique “bone loss accelerant” that occurs at the start of middle age: menopause.
In addition to regulating monthly menstruation, estrogen plays a critical role in continued bone health. When this all-important hormone starts declining in the years leading up to menopause (perimenopause), osteopenia can develop.
And once you reach menopause (12 months without a menstrual period), estrogen loss can have a major effect on your bones: A woman can lose up to 20% of her bone density in the first five years after menopause, laying the foundation for osteoporosis.
The problem with osteoporosis is that it’s a “silent” disease, or one that takes root and progresses without causing unmistakable symptoms; the postural changes, loss of height, and lower back pain it can cause are often ignored or dismissed as something else.
Usually, a broken bone is the first obvious sign of substantial bone density loss: Half of all women aged 50 and older sustain a bone fracture because of osteoporosis, and many only find out they have the condition when seeking treatment.
Luckily, osteoporosis isn’t inevitable following menopause, and there are steps you can take to support healthy bones at any age. Whether you’re in your thirties, forties, fifties, or beyond, you can minimize your risk of future bone loss by:
Dr. Ibrahim can also provide a bone-loss prevention plan, including guidance to lower your osteoporosis risk, along with regular bone density screenings to monitor your skeletal health as you age.
You may also benefit from hormone replacement therapy (HRT), which can both alleviate menopausal symptoms like night sweats and help halt or reverse estrogen-related bone loss.
Proactive bone health management is an essential part of women’s preventive health care — especially when menopause is on the horizon. We can help: Contact New Beginnings OB/GYN in Shenandoah, Texas, to schedule a visit with Dr. Ibrahim today.