Menopause can, in some cases, lead to Osteoporosis - a condition that weakens bones.

--BY DR PRAVIN NEPAL

Menopause is a time in a woman’s life when she stops having monthly periods. During this time, her ovaries stop releasing eggs and stop producing estrogen and progesterone hormones. Menopause usually occurs between the ages of 45 and 55. There is a direct relationship between the lack of estrogen and the development of osteoporosis. After menopause, bone resorption (breakdown) overtakes the building of new bones. Early menopause (before age 45) and any long phases in which a woman has low hormone levels and infrequent menstrual periods can cause loss of bone mass.

Though we do not know the exact cause of osteoporosis, we do know how the disease develops. Women typically build up more bone than they lose until they are 30 years of age. After this, the bone break up takes over the bone building, this causes a gradual loss of bone mass. When this loss reaches a certain point, then a person has osteoporosis.       

Pain in the lower back, at the hip joint and sometimes all over the body is a symptom of the disease. Worldwide, osteoporosis causes more than 8.9 million fractures annually, of which over 4.5 million occur in the Americas and Europe. The lifetime risk for a wrist, hip or vertebral fracture has been estimated to be 30 to 40 percent in developed countries. Osteoporosis is not only a significant cause of fractures; it also ranks high among diseases that cause people to become bedridden with serious complications. These complications may be life threatening to older people.

How Will You Know?
If a woman discovers that she is suffering from menopause, then it is always better to check calcium, phosphorus, alkaline phosphate and vitamin D levels regularly. Further, Bone mineral density (BMD) tests are X-rays that use small amounts of radiation to determine bone density. In addition to measuring bone health, these tests can determine how severe any osteoporosis is. Although measurement of bone mineral density with dual x-ray absorptiometry is considered the gold standard for diagnosis of osteoporosis, it has some limitations. Because of these limitations of dual x-ray absorptiometry, efforts have been made to formulate a system to predict fracture risks better.

Based on a series of meta-analyses undertaken to identify clinical risk factors for osteoporosis, the Fracture Risk Assessment Tool (FRAX) was developed.  FRAX aims to provide an assessment tool for the prediction of fractures in men and women with the use of clinical risk factors with or without femoral neck bone mineral density. These clinical risk factors include age, sex, race, height, weight, body mass index, a history of fragility fracture, parental history of hip fracture, use of oral glucocorticoids and rheumatoid arthritis. The treatments for Osteoporosis include weight-bearing exercises, calcium and vitamin D supplementation and other anti-osteoporotic medicines.

Prevention of Osteoporosis:
1. Exercise:
    Exercise regularly. Exercise makes bones and muscles stronger and helps prevent bone loss. It also helps you stay active and mobile. Weight-bearing activities, done three to four times a week, are ideal for preventing osteoporosis.

2. Get enough calcium:
    Getting enough calcium throughout your life helps to maintain strong bones. Some good sources of calcium are milk and dairy products; a variety of seafood, such as canned fish with bones like salmon and sardines; dark green leafy vegetables, such as kale, collards and broccoli; calcium-fortified orange juice; and bread made with calcium-fortified flour.

3. Consider precautions while taking certain medications:
    Some medications, including steroids, certain drugs used to treat seizures (anticonvulsants), blood thinners (anticoagulants), and thyroid medications increase the rate of bone loss if not used as directed. If you are taking any of these medications, speak with your doctor about how to reduce your risk of bone loss through diet and lifestyle changes.

4. Don’t smoke or drink alcohol:
    Limit the amount of alcohol you drink and do not smoke. Smoking hinders estrogen production. Similarly, too much alcohol can damage your bones and increase your risk of falling and breaking a bone.

   Menopause is an unavoidable circumstance every woman has to face. A little bit of extra care in daily life will make a huge difference.

The writer is Senior Consultant Orthopedic Surgeon at Norvic International Hospital.