As women age and experience menopause, they’re likely to notice many significant changes in their bodies. While some of these changes may be temporary for the duration of menopause, some can impact the body for years to come. One of these possible enduring shifts is osteoporosis, requiring careful treatment in order to minimise the ongoing effects.
What is osteoporosis?
Osteoporosis is a condition characterised by weakened bones that are prone to fracturing easily. While osteoporosis is experienced by men and women alike, many women find themselves at risk of developing osteoporosis after menopause, as oestrogen plays a crucial role in maintaining bone strength.
After menopause, a woman’s oestrogen levels drop, which can result in increased bone loss. Up to 10% of the average woman’s bone mass is lost in the first five years after menopause, with research suggesting that approximately half of all women above the age of 60 experience at least one fracture due to osteoporosis.
Osteoporosis remains under-diagnosed and under-treated, even with effective prevention and treatment options available. Educating women about the risks of osteoporosis before they enter their menopausal years can lead to increases in preventative activities, as well as the knowledge to seek treatment should osteoporosis occur.
Why osteoporosis takes place
Our bones constantly cycle between resorption and formation throughout life. Osteoporosis takes place when resorption happens more quickly than formation, resulting in a loss of bone strength and density. As a result, bones are more fragile, meaning they are more prone to fractures.
Osteoporosis is most commonly identified when a fracture occurs, which is the only time it directly results in pain. Fractures as a result of osteoporosis and bone resorption are most common in the spine, hip and wrist, which become more at risk of fracture as they’re weakened with age.
How to minimise the risk of osteoporosis
While some elements of ageing are unavoidable, the risk of developing osteoporosis can be lessened via careful preventative measures. These include ensuring adequate dietary calcium on a daily basis, the maintenance of adequate vitamin D levels, regular physical activity, a non-smoking lifestyle and the consumption of caffeine in moderation. A regular exercise routine throughout life can lead to reductions in the risk of osteoporosis, alongside other significant benefits. Vigorous exercise can result in the best benefits, with strength training, swimming and any exercise that focuses on improving muscle strength and balance leading to improved risk outcomes.
The importance of bone health as we age
Bone health is of crucial consideration at every stage of life. As our skeletons store calcium – a mineral necessary to our everyday bodily functions – supporting healthy bones is key to ensuring longevity and healthy ageing.
Peak bone mass refers to our maximum bone size and strength, with genes playing a significant role in the amount of peak bone we have. Lifestyle factors, such as diet and exercise, can also have an impact on whether or not we each reach our full bone mass potential.
While childhood, adolescence and early adulthood are the stages where we can significantly impact our peak bone mass through diet and exercise, ongoing lifestyle choices can also contribute to our bone strength.
Our bone mass begins to slowly deplete around the age of 40, although we can take significant steps to avoid severe bone loss (as noted above).
Treatment options for osteoporosis
Osteoporosis treatments are focused on management, looking to minimise the impact of osteoporosis on daily health and long-term longevity. There’s a wide range of medical treatments available that can assist in this management. These focus on strengthening existing bones, preventing further bone loss and aim to reduce the risk of broken bones.
Hormone replacement therapy has demonstrated significant benefits in the treatment of osteoporosis as a relatively inexpensive treatment. Additionally, benefits include quality of life improvements. The major underlying cause of postmenopausal osteoporosis results from the loss of bone connected to oestrogen deficiency. Hence, hormonal replacement therapy (HRT) is a rational approach in both peri- and postmenopausal women[1].
The Global Consensus Statement on Menopausal Hormone Therapy is endorsed by the American Society for Reproductive Medicine, the Asia Pacific Menopause Federation, the Endocrine Society, the European Menopause and Andropause Society, the International Menopause Society, the International Osteoporosis Foundation and the North American Menopause Society. Within this, it
[1] Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Prz Menopauzalny. 2014 Sep;13(4):213-20. doi: 10.5114/pm.2014.44996. Epub 2014 Sep 9. PMID: 26327857; PMCID: PMC4520366.
[1] Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Prz Menopauzalny. 2014 Sep;13(4):213-20. doi: 10.5114/pm.2014.44996. Epub 2014 Sep 9. PMID: 26327857; PMCID: PMC4520366.
was stated that HRT is effective and appropriate in the prevention of osteoporosis-related fractures in at-risk women who are younger than 60 years old or are within 10 years of menopause[1].
This positions HRT as a first-line therapy for the prevention and treatment of osteoporosis-related fractures. Hormone replacement therapy has been found to decrease the incidence of all osteoporosis-related fractures, such as vertebral and hip fractures. Not only does HRT reduce osteoporosis-related fractures, but it’s also been found to reduce the number of fractures even in women without osteoporosis[2].
The benefits of HRT
Find support for many other symptoms or side effects of menopause within hormone therapy treatment. The Australian Menopause Centre offers confidential, obligation-free medical phone consultations that can empower you with insights as to how HRT may serve you via a tailored treatment program. We’re helping women all over Australia navigate menopause. With our first stage being focused on your medical history, and the second stage a confidential discussion with a menopause doctor, you’ll be supported with a customised approach to increasing your bone strength and reducing the risk of osteoporosis impacts.
Find relief from a wide range of menopause symptoms with the support of a clinical team that assists our patients at every step. Contact us to learn more about how HRT can support you in the fight against osteoporosis and other menopause-related impacts.
[1]Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Prz Menopauzalny. 2014 Sep;13(4):213-20. doi: 10.5114/pm.2014.44996. Epub 2014 Sep 9. PMID: 26327857; PMCID: PMC4520366.
[2] Fait T. Menopause hormone therapy: latest developments and clinical practice. Drugs in Context 2019; 8: 212551. DOI: 10.7573/dic.212551 1 of 9 ISSN: 1740-4398
[1]Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosis. Prz Menopauzalny. 2014 Sep;13(4):213-20. doi: 10.5114/pm.2014.44996. Epub 2014 Sep 9. PMID: 26327857; PMCID: PMC4520366.
[1] Fait T. Menopause hormone therapy: latest developments and clinical practice. Drugs in Context 2019; 8: 212551. DOI: 10.7573/dic.212551 1 of 9 ISSN: 1740-4398
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