Menopause and bone health

Best ways of staving off post menopausal bone weakness.



Our last blog concentrated on the effects on menopause on the soft tissues of our musculo-skeletal system ( MSK ) and today we are addressing the effect on our bones. Post menopausal osteoporosis is probably one of the more well documented and commonly recognised sysmptoms of menopause. Osteoporosis is a loss of bone mass density ( BMD ) as can be seen in the picture above, the internal scaffolding of the bone becomes more sparse and weakens the bone causing pain and making it more vulnerable to fracturing easily. It can occur in men too but it is far more common in women ( 20% in females and just 1% in men ) so whilst I'm not ignoring you chaps, this article is focusing more on the ladies but the advice at the end can work equally well for men too... mostly !



So what is the link between menopause and Osteoporosis ?

Again it's the link between collagen and our hormones. Remember collagen, the most abundent form of protein in our bodies ? Well as well as making up our soft tissues like ligaments, cartilage, tendons and muscle, it's also the base ingredient for our bones . This collagen matrix is impregnanted with calcium to strengthen it. Bone is a living, evolving tissue with cells both creating new and absorping old, spent bone. This system is balanced throughout our lives but if more bone is absorped than is created we have a problem ! The internal bone scaffolding weakens and it becomes easier for the bones to deform or break under a relatively low impact. It can happen in any bone but there are certain hot spots in our skeleton that are more vulnerable to this happening :

  • Neck of the thigh bone ( femur )

  • Vertebrae of the spine

  • Ribs

  • Upper arm / shoulder

  • Wrist

  • Pelvis

So why can't we just increase the amount of bone we create to balance it out ? As active as our skeleton is it reaches it's maximum capacity of bone in our mid 20's.... there are slight variations but largely speaking it's true that what we have in our 20's is the most bone we will ever have. After that it's a balancing game which for the most part we manage well until that is ( as women ) we come to menopause when our bone stocks drop off a cliff ! Our oestrogen has hugely beneficial protective properties for our skeleton with women losing up to 20% of their bone stocks in the first ten years of menopause.


Hormone Replacement Therapy - is it the answer ?

By far and away the best way of staving off ostoporosis is to continue with the protective effect of our hormones and post menopause that means HRT. It has been for many women such a contentious issue and many were wary of turning to HRT after previous research implicated it's use may pose a higher risk of developing of other diseases, most notably breast cancer. This research was done nearly 40 years ago and both our undestanding of menopause AND the drugs used have changed radically leading to a new way of approaching HRT. As we alluded to in our previous blog there has been much interest and research in it's long term use - particularly in relation to it's role in preventing osteoporosis - and it is extremely encouraging.


And prevention of osteoporosis is one of the strongest indicators for the use of HRT - bone density increases in ALL women using HRT with overall a 35% reduction in fractures around the hip and spine. Even more importantly the age at which HRT starts is not a significant factor - you get the same increase in bone density irrespective of whether you started HRT at 45 or 60 so it's never too late.


As with any new regime discuss with your GP whether it is suitable for you, it isn't for everyone, but there are a myriad of ways to take HRT these days including patches, gels, nasal sprays and pessaries which may benefit you in terms of your overall health.


Other easy ways to help maintain healthy bones pre AND post menopause !

  1. Exercise - Specifically weight-bearing exercise. the stress of weight going through the bones actually stimulates the osteoclast cells to manufacture bone. So think walking, tennis,

  2. Stop smoking - smoking has been linked with an increased chance of an early menopause and women who smoke have increased frequency and severity of hot flushes. It's just another good reason to kick the fags !

  3. Suppliments - more anectodal evidence but many women find alcohol makes hot flushes, mood swings and night sweats. Alcohol is a well known depressant and menopausal women are particularly vulnerabel to low mood so limiting intake would seem wise.




We are always here to help and happy to have an informal chat if you are not sure which direction is best for you, feel free to give us a ring to discuss your needs.



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