Bone Loss in Midlife: What Menopause Has to Do with It

One of the more chronic and serious results of menopause is the loss of bone density, also known as osteoporosis. Postmenopausal bone loss is serious because women with osteoporosis are more likely to experience unexpected bone fractures and breaks due to an overall weakening of their bones. It’s also more common than you might think: The National Osteoporosis Foundation says that roughly one in two women over the age 50 will break a bone because of osteoporosis.¹

Roughly one in two women over 50 will break a bone because of osteoporosis.

Because osteoporosis in menopause doesn’t often present itself through tangible or obvious symptoms, many women don’t realize they have it until they actually fracture a bone. In order to combat the onset of osteoporosis, it’s important that women maintain healthy eating habits and ensure their healthcare provider is monitoring bone density and calcium levels when appropriate.

Menopause Bone Loss & Fracture Risk

The relationship between menopause and osteoporosis is well-established, according to The Journal of The Menopause Society.² Bone health relies on a delicate balance between osteoblasts, cells that build new bone, and osteoclasts, cells that break down bone to repair, remodel and maintain healthy bone. Estrogen is intricately related to this function. And as estrogen fluctuates and eventually declines with menopause, it may lead to a higher risk of osteoporosis.³

Osteoporosis Symptoms in Menopause

Osteoporosis is often called “the silent disease,” as it can be hard to detect until you experience a bone fracture or break. Severe back pain, loss of height, and spine deformities, such as a hunched back, are more serious signs of osteoporosis. Other signs you may be at higher risk for osteoporosis include high levels of serum calcium in blood tests, difficulty standing up, and bone and muscle aches.⁴

It’s often difficult to identify osteoporosis in menopause until a fracture occurs. For this reason, women who are experiencing perimenopause and menopause should take preventive steps to lower their risk, such as preventing falls and obtaining adequate calcium and vitamin D.

Bone Density in Menopausal Women

One of the best steps you can take when it comes to preventing osteoporosis, is monitoring your bone density through bone density tests for women. Regular tests can ensure that bone density changes are identified at an early stage. Tracking bone density over time will help you and your healthcare provider evaluate if and when you may require treatment.

“Bone density testing will be done typically by 65, but often earlier in women who have risk factors. This testing may let us know whether treatment with medication might be needed.” — Dr. Alyssa Dweck, Bonafide Chief Medical Officer

Dr. Dweck says thin, white women tend to be at higher risk for osteoporosis during and after menopause. A family history of osteoporosis, specific medical problems, and smoking or alcohol use can also increase your risk. Talk to your healthcare provider if you think you may be a candidate for earlier bone density testing.

Tips to Prevent Menopause Bone Loss

As you approach the menopause transition, your nutrient intake needs to change. Along with decreased levels of estrogen, levels of vitamin K and vitamin D in your body also decrease during this time. During midlife, you should also consider increasing your intake of calcium-rich foods as adequate calcium in menopause is extremely important. Dr. Dweck recommends getting at least 1200mg of calcium, mostly through dietary intake, and 800 international units of vitamin D every day. Good sources of calcium include fortified dairy products, salmon, almonds and dark leafy greens like kale, collards, and spinach. If you feel that you still aren’t getting enough calcium, vitamin D, and vitamin K in your diet, consider taking a supplement.

Regular exercise also helps maintain or increase bone and muscle mass. Strength training becomes particularly important as you age in helping prevent postmenopausal bone loss. Dr. Dweck explains that weight-bearing activities help with balance, strength and flexibility — all of which may help prevent falls that can lead to broken bones. Consistent strength training is important during menopause, but afterwards as well: women in postmenopause can maintain or even gain as much as 1.5% in bone mineral density with a proper workout routine.⁵

Resources

1. https://www.nof.org/preventing-fractures/general-facts/what-women-need-to-know/
2. https://journals.lww.com/menopausejournal/Fulltext/2020/08000/Association_between_osteoporosis_and_menopause_in.9.aspx
3. https://www.endocrineweb.com/conditions/osteoporosis/osteoporosis-osteoporosis-women
4. https://www.everydayhealth.com/osteoporosis/early-signs-of-osteoporosis.aspx
5. https://www.womenshealthnetwork.com/bone-health/bones-menopause/