written by: Dr Mike C
• edited by: Diana Cooper
• updated: 11/8/2010
A woman's fertility begins at puberty with the onset of the first menstrual bleeding and ends at the menopause. Both of these events are marked by hormonal changes in a woman's body. The risk of osteoporosis post menopause increases due to a decline in estrogen levels. It can be treated by HRT.
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Most people erroneously believe that once they are fully grown their bones don’t change anymore. In reality, bone tissue is continuously lost and replaced; a process known as bone remodelling. As people age, the rate at which bone is lost may begin to outstrip the rate at which new tissue can replace it which leads to lowering of bone density with a consequent decrease in bone strength and an increased likelihood of fracture.
Osteoporosis literally means porous bone. It is a condition in which the bones (usually in an adult) get weaker over time and are consequently at greater risk of a fracture (i.e. they break more easily). According to the US National Institutes of Health, half of women over the age of fifty, and a quarter of men of that age, will suffer a broken bone due to osteoporosis – so it is a very significant condition affecting many people. In the disease, the bones of the patient become less dense and more fragile over time.
The condition often develops unremarked, until a bone is broken and the sufferer is given a bone mineral density examination.
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A woman generally becomes able to bear children at puberty and can continue to do so until after the menopause. Both of these major life events are mediated by hormonal changes within the woman’s body. The average age for the onset of the menopause is 51 and it is defined as having taken place when the woman completes twelve menstrual cycles without any menstrual bleeding. The risks of osteoporosis post menopause do increase and are linked to the falling off of the female sex hormone estrogen. Some evidence for this is to be found by comparing osteoporosis incidence between women that have undergone a premature menopause against women of the same age who have not (and consequently have higher estrogen levels).
The most common bone fracture due to osteoporosis post menopause is a compression fracture of the vertebrae in the spine (although this may go unnoticed by the sufferer). Repeat fractures become more likely and ultimately the condition may lead to curvature of the spine and height loss. Fractures of the hip due to osteoporosis are less common than spinal compression fractures; however, they can be much more serious. Astoundingly, in the USA, a quarter of hip fracture victims over 50 will die within a year of the fracture from related causes such as pneumonia due to reduced mobility. Only one in three women suffering from a hip fracture will recover sufficiently to live independently after their fracture.
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Treatment And Prevention Of Osteoporosis
Lifestyle and dietary changes may help to reduce problems associated with osteoporosis. Additionally, treatments have been developed which are designed to maintain bone density such that the problem doesn't worsen. In some post menopausal women, hormone replacement therapy may be offered, but all sufferers benefit from a good diet which is rich in calcium; an essential mineral for bone health. Hormone replacement therapy involves supplementing the body with oestrogen to compensate for the decline of this hormone after the menopause. Normally, hormone replacement therapy would also involve treatment with progesterone since evidence suggests that oestrogen only therapy may lead to cancer of the womb in some cases. Exercises may also be advised to help build muscle to improve the patient’s balance, muscle strength and agility. It is also advisable to take steps to reduce excessive weight both within a general health context but also as a measure to reduce the stress on weakened bones.
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US National Library of Medicine: http://www.nlm.nih.gov/medlineplus/osteoporosis.html
International Osteoporosis Foundation: http://www.iofbonehealth.org/patients-public/about-osteoporosis/what-is-osteoporosis.html
North American Menopause Society: http://www.menopause.org/