Menopause and osteoporosis – what’s the link? Menopause causes a wide variety of changes in the female body, as estrogen levels decrease, and the menstrual cycle stops. Estrogen is an important female sex hormone with many vital roles in the body, one of which is maintaining the health and function of the bones. Bone mass often decreases as estrogen levels decline, which can eventually lead to the development of osteoporosis.
Menopause & Bone Health
What Happens During Menopause?
In the months and years leading up to menopause (i.e. perimenopause) your ovaries start to produce less of a sex hormone called estrogen.[i] Estrogen has many important roles in the female body, and it is one of the key hormones involved in ovulation and menstruation. Once a woman has reached menopause, her ovaries will no longer release eggs and her period will stop altogether.
What’s the link between Bone Health, Menopause and Osteoporosis?
Estrogen is a key female sex hormone that drives the development of all female sexual characteristics.[ii] It is essential for normal ovulation and menstruation, but also has vital functions in several other body systems. For example, estrogen is also important for maintaining the health of the skin, heart, and bones.
When women go through menopause, their declining estrogen levels can have a negative effect on their bone health. Estrogen is essential for bone health in the female body, as it promotes the activity of osteoblasts[iii] (specialized cells that produce bone tissue). Therefore, estrogen helps to prevent bone loss and keeps bones strong and healthy.
When estrogen levels begin to fall, osteoblasts become less active and are less able to produce bone tissue. At the same time, the number of osteoclasts (bone absorbing cells) increases. As a result, your bones start to lose mass, get thinner, and are more prone to breakage and fracture.
What is Osteoporosis?
Bone mass naturally decreases with age in both men and women. After around age 30, bone tissue is lost more quickly than it is created[iv] and, as a result, the bones start to ‘thin out’ and become weaker.
Osteoporosis is a condition in which the bones become so weak and brittle that a simple fall can cause them to fracture or break. The older you are, the more likely you are to develop osteoporosis. However, the disease is far more common among women than men, and this is probably due to the role of estrogen in maintaining female bone health.
Menopause and Osteoporosis – is Menopause the Cause?
Menopause is characterised by a drop-off in the production of estrogen by the ovaries, and estrogen is crucial for the maintenance of female bone health. This loss of estrogen causes a decrease in the number of osteoblasts[v] (bone forming cells) and an increase in the number of osteoclasts (bone absorbing cells). Therefore, reduced estrogen levels cause the bones to lose mass and thin out more rapidly than before. Eventually, this can lead to the development of osteoporosis.
The early stages of osteoporosis typically don’t have any symptoms but, as the diseases progresses, you may notice:
- Back pain
- Loss of height over time
- Stooped posture
- Bones that fracture or break surprisingly easily
How Can You Keep Your Bones Healthy After Menopause?
Osteoporosis and bone health generally is best addressed early. By the time many of the above symptoms emerge, the problem can be quite advanced. However, bone issues can be both identified and predicted before these symptoms appear. There are specific tests to look at bone health or deterioration that our menopause doctors can discuss with you if this is an area of concern.
There are also several lifestyle habits you can adopt to help preserve your bone health as you age, for instance increasing appropriate weight-bearing physical activity and management of certain supplements. This is important for both men and women, but especially for women who are nearing or beyond the age of menopause.
If you already have osteoporosis, there are medical treatments available that can help with symptom management. If you have any concerns about menopause or other health conditions relating to menopause, schedule an appointment with either Dr Madhavi Manoharan, OBGYN or Dr Lisa Joels, OBGYN, both of whom have extensive experience in managing menopause symptoms and related conditions and who would be delighted to discuss your issues further. Both of our menopause doctors are highly qualified in the identification and treatment of all health conditions relating to menopause and associated endocrinological problems, and can expertly answer any health queries you may have.
References
[i] https://www.webmd.com/menopause/guide/menopause-basics
[ii] https://www.news-medical.net/health/What-Does-Oestrogen-Do.aspx
[iii] https://www.endocrineweb.com/conditions/osteoporosis/oestrogen-replacement-therapy-osteoporosis#:~:text=Oestrogen%20is%20a%20sex%20hormone,able%20to%20effectively%20produce%20bone.
[iv] https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968
[v] https://www.medscape.com/answers/330598-82968/what-is-the-role-of-oestrogen-deficiency-in-the-pathogenesis-of-osteoporosis#:~:text=Oestrogen%20deficiency%20increases%20the%20number,oestrogen%20level%20in%20postmenopausal%20women
