Preventing bone loss is an important concern for women in the menopause and during post-menopausal stages. Menopause significantly speeds bone loss and increases the risk for osteoporosis. Research indicates that up to 20% of bone loss can happen during these stages and approximately 1 in 10 women over the age of 60 are affected by osteoporosis worldwide.
Osteoporosis is a disorder associated with low bone mass where bones become naturally weak, increasing the likelihood of fractures (bone breaks). Bones in the hip, spine, and wrist are especially prone to fragility fractures in older adults with little or no evidence of trauma. Osteoporosis is more common in women because menopause can accelerate bone loss causing the bones to break down more quickly than it is formed.
Osteoporosis: a progressive condition in which bones become structurally weak and are more likely to fracture or break
Osteopenia: low bone mineral density where the body does not make new bone as fast as the old bone is absorbed
Bone turnover markers: a test in the laboratory of bone resorption or bone formation
BMD: bone mineral density is the amount of calcium and other minerals in your bone tissue
DXA: Dual energy x-ray absorptiometry a test to measure bone mineral density (BMD)
T-score: the units of standard deviation away from the mean for a 35-year-old woman measured by bone mineral density; a negative score means lower bone mineral density than a 35-year-old woman
(FRAX) fracture risk assessment: a measure of the vertebrae to assess whether it has fractured using bone density measurements
Osteoporosis is often called “a silent disease” usually determined with the first fracture. It can also be diagnosed by measuring the reduction of bone density. However, any fracture in postmenopausal women or in elderly men can be considered due to osteoporosis unless related to a motor vehicle accident or major trauma. Common symptoms include:
As hormones change to accommodate normal menopausal changes, estrogen levels start to fluctuate and then drop. Estrogen helps prevent bones from getting weaker by slowing the natural breakdown of bone. Menopause is the most common cause of osteoporosis. One in two postmenopausal women will have osteoporosis and most will suffer a fracture during their lifetime. Fractures (bone break) cause pain, decreased mobility, and function. Fear of falling and are associated with decreased quality of life and increased mortality.
It is never too late to be treated for osteoporosis, and in fact, older women are more likely to respond better to treatment if given early. The goal of your treatment plan is to decrease fractures associated with osteoporosis and maintain good bone health. Lifestyle changes that can improve bone health are:
There are many drugs and hormone therapies available to prevent further bone loss and to stimulate new bone formation. Any fracture occurring after menopause should be considered an osteoporotic fracture and should be aggressively treated with one of several possible drugs or therapies:
Current treatments are very effective and lower the risk of further harm. Duration of treatment will vary depending on a women’s fracture risks, long-term effects of therapy on bone health, and other risks or side effects. Treatments should be a shared decision with you and your healthcare team.
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