Menopause is a major milestone in a woman’s life, marked by the end of the reproductive period and a series of significant physiological changes. Among these changes, the impact on bone health is one of the most concerning. Indeed, with the decrease in estrogen levels, postmenopausal women face an increased risk of bone density loss and the development of osteoporosis. Learn more about the impact of menopause on bone health in this article!
How does menopause affect bone health?
Decrease in estrogen levels after menopause
Estrogen plays a crucial role in regulating bone remodeling , a process by which old bone tissue is replaced by new bone tissue. This process is essential for maintaining bone density and strength . Estrogen inhibits the activity of osteoclasts, the cells responsible for bone resorption, which helps maintain the balance between bone formation and resorption.
At menopause, estrogen levels decrease significantly . This decrease results in increased osteoclast activity, which leads to increased bone resorption and, consequently, loss of bone density .
Accelerated bone loss
Bone density loss is most rapid during the first few years after menopause . On average, women can lose up to 2–3% of their bone mass per year during the first five to ten years after menopause.
After this initial period, bone loss continues at a slower rate, but it persists throughout life.
Increased risk of osteoporosis and fractures
- Osteoporosis : This condition is characterized by fragile and porous bones, increasing the risk of fractures. After menopause, the risk of developing osteoporosis increases significantly.
- Fractures : Hip, spine, and wrist fractures are particularly common in postmenopausal women. Vertebral fractures can lead to height loss and chronic back pain, while hip fractures can have serious consequences, including loss of mobility and increased risk of mortality.
Aggravating factors
In addition to the simple menopause phase, certain conditions can also worsen postmenopausal bone loss, such as:
- A family history of osteoporosis or fractures
- Sedentary lifestyle : Lack of exercise can accelerate bone loss
- Smoking : This practice can reduce bone density and increase the risk of fractures
- Excessive alcohol consumption : This can also negatively affect bone health
- Calcium and vitamin D deficiencies : A diet low in these essential nutrients contributes to bone loss
Assess bone health
It is entirely possible to assess your bone health during menopause. Here are the main methods used for this assessment.
Bone densitometry
Bone densitometry , or DEXA (Dual-Energy X-ray Absorptiometry), is the most commonly used test to measure bone mineral density (BMD). It uses low-dose X-rays to determine bone density in specific areas, usually the spine, hip, and sometimes the forearm. It is a quick, noninvasive, and accurate test to diagnose osteoporosis and assess fracture risk.
Bone ultrasound
Bone ultrasound is a method that uses sound waves to measure bone density, traditionally at the heel. Although it is less accurate than bone densitometry, it can be used as a screening test. It is a quick, non-invasive method, without exposure to X-rays, and often less expensive.
Blood and urine tests
Certain biochemical markers in the blood and urine can indicate the rate of bone turnover. For example, levels of calcium, phosphorus, vitamin D, and markers of bone formation (such as osteocalcin) and bone resorption (such as CTX and NTX) can be measured. These tests can provide information about bone metabolism and the effectiveness of osteoporosis treatments.
Limiting the effects of menopause on bone health
While the impact of menopause on bone health is inevitable, it can be limited. Indeed, there are preventive measures and strategies to adopt. Here are some recommendations in this section.
A balanced diet
- Increase calcium intake : Postmenopausal women should aim for a daily intake of about 1,200 mg of calcium. Food sources rich in calcium include dairy products (milk, yogurt, cheese), leafy green vegetables (broccoli, kale), almonds, canned sardines, and calcium-fortified products such as orange juice and cereals.
- Ensure adequate vitamin D intake : Vitamin D is crucial for calcium absorption. Postmenopausal women should aim for a daily intake of 800 to 1000 IU. Vitamin D can be obtained through sun exposure, certain foods (oily fish, liver, egg yolks), and supplements.
Regular physical exercise
- Resistance and strength training exercises : These exercises, such as walking, running, stair climbing, and strength training, are effective for strengthening bones.
- Balance and flexibility exercises : Exercises like yoga and tai chi help improve balance and prevent falls, reducing the risk of fractures.
A healthy lifestyle
- Avoid smoking : Smoking is associated with decreased bone density and an increased risk of fractures.
- Limit alcohol consumption : Excessive alcohol consumption can interfere with calcium absorption and compromise bone health. It is recommended to limit consumption to one drink per day for women.
- Maintain a healthy weight : Being overweight or underweight can negatively affect bone health. A healthy weight can help reduce the risk of fractures.
Supplements and medications
- Calcium and vitamin D supplements : If dietary intake is inadequate, supplements may be needed to achieve recommended intakes of calcium and vitamin D.
- Bone health medications : Depending on bone density and individual risk factors, a doctor may prescribe medications to prevent or treat osteoporosis. This includes bisphosphonates, raloxifene, hormone replacement therapy (HRT), and other agents.
- Food supplements : on our site, you can find a category of products suitable for menopause, including this food supplement based on macerate of young bramble shoots , ideal for strengthening the osteoarticular system.
Regular medical monitoring
- Bone densitometry : Postmenopausal women, especially those at high risk for osteoporosis, should have bone mineral density tests to assess their bone density and monitor changes over time.
- Regular medical consultation : Regular visits with a healthcare professional allow bone health to be monitored, risk factors to be discussed, and treatments or preventive interventions to be adjusted if necessary.
Conclusion
Menopause is a transitional period that, while natural, presents significant challenges to women’s bone health. Decreased estrogen levels lead to accelerated bone loss, increasing the risk of osteoporosis and fractures. However, with a proactive and well-informed approach, it is possible to limit these effects. A diet rich in calcium and vitamin D, regular physical activity, and healthy lifestyle habits are essential to maintaining good bone health.
