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Menopause and Bone Health

We tend to imagine bones as solid, static pieces of mass, but they are in fact an organ that is constantly remodelling through a never ending process of breaking down and building back up again. When bones are put under pressure through strength or weight training, they respond by depositing more calcium and phosphate into their structure to make them stronger.

 

When someone goes through peri-menopause, their ovaries begin to slow down their production of the hormone oestrogen. By menopause, oestogren levels are very low. When oestrogen circulates in the blood, it communicates with many organs and tissues around the body, including the bones. Oestrogen stimulates the cells of the bone that are responsible for increasing mass and making them stronger, so when someone goes through menopause, their bones stop having that positive influence of oestrogen to stimulate their growth (1)

According to research, 20% of bone loss occurs during menopause, which contributes to 1 in 10 women over 60 years of age having a condition called osteoporosis (2). Osteoporosis is the term used to describe weaker bones that are prone to fracture. When a bone has osteoporosis, the inside begins to look like the porous inside of an aero bar, when it should look like the more solid inside of a crunchie!

The risk and consequences of bone fracture are often underestimated. Weaker bones often exists alongside weaker muscles, which means that fracture rehabilitation and recovery is a very challenging road for a lot of fracture patients. Not only does a fracture impact someone’s physical health, but the lack of activity during the recovery phase can impact their mental health and the challenge of participating in social activities during recovery can have further impacts that all contribute to morbidity.

 

But fractures can be much more sinister and in the elderly demographic are a major cause of mortality. A common fracture associated with osteoporosis in the post menopausal female demographic is the neck of femur fracture (NOF). A study in Aus showed that 8.1% of patients had died at 30 days and 21.6% had died at 1 year. (3)

The best way to approach this significant complication of menopause is to know your personal risk factors, adjust or maintain your diet specific to vitamin D and calcium, and introduce specific bone and muscle strengthening exercises. Hormone replacement therapy is an important factor to consider too, as maintaining healthy oestrogen levels will help to protect your bones. Speak to your doctor about whether HRT is right for you. 

 

References:

  1. Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton. Trends Endocrinol Metab. 2012 Nov;23(11):576-81. doi: 10.1016/j.tem.2012.03.008. Epub 2012 May 16. PMID: 22595550; PMCID: PMC3424385.
  2. Endocrine Society."Menopause and Bone Loss | Endocrine Society." Endocrine.org, Endocrine Society, 9 January 2024, https://www.endocrine.org/patient-engagement/endocrine-library/menopause-and-bone-loss
  3. Chia PH, Gualano L, Seevanayagam S, Weinberg L. Outcomes following fractured neck of femurin an Australian metropolitan teaching hospital. Bone Joint Res. 2013 Aug 15;2(8):162-8. doi: 10.1302/2046-3758.28.2000177. PMID: 23950158; PMCID: PMC3746209.