Why does the menopause cause Osteoporosis?
It may surprising to learn that our bones are continually being absorbed, repaired and re-modelled. This happens through a precise balance between two types of cells; osteoblasts that form new bone and osteoclasts that absorb the bone. Every day we lose bone and make new bone, and up to the age of around 40 this balance is blissfully co-ordinated and happy.
When menopause happens, whether it’s an early surgical menopause or natural menopause, something happens that makes the osteoclasts take over and more bone is being eaten away than the osteoblasts have a chance to make and bones become more fragile, potentially leading to Osteoporosis, literally meaning porous bones.
The amount of bone you have before you reach the menopause has a huge effect on your risk of developing bone loss or osteoporosis. The main risk factors are being underweight, being a smoker, taking steroid medication and then there are the genetics that we can’t do much about. Our ethnicity is also a risk factor; women of Caucasian and Asian heritage are at higher risk of bone loss and osteoporosis than women of African heritage.
Bone loss is a natural factor in ageing so men will experience some bone loss too, but their bones are thicker and stronger than women’s to start with and they don’t experience the hormonal effect on bones that women do.
Sometimes it feels like female hormones are our enemy, causing us all kinds of troubles ranging from PMT to POC. Sure, female sex hormones allow us to bear children and breastfeed and contribute towards our nurturing nature, but once we get to menopause it’s like our bodies properly turn on us.
Menopause happens because our bodies stop producing as much estrogen and this drop in estrogen causes the osteoclasts (the bone destruction cells) to become more powerful and the osteoblasts (the bone building) to become less effective.
So while we’re going about our glamourous lives and making huge efforts to look our best, our bones are doing their own thing, wilfully ignoring that we look fabulously younger than our years, and in order to age-proof our bones, we have to make serious effort in terms of life-style, exercises and nutrition, and we have to start now.
So what is our roadmap to preventing bone loss in Menopause:
· Increase exercises that load our bones to make them stronger. These exercises are walking, especially Nordic walking, jogging, dancing and exercises using weights or resistance bands.
· Improve nutrition to include ‘bone building foods’ that are high in natural Calcium, vitamins, especially Vitamin D and phyto-estrogens.
· Take extra vitamins such as Vitamin D if not able to get enough from food.
· HRT, Hormone Replacement Therapy, has benefits for some women to reduce bone loss.
· Biphosphonate, such as Alendronic Acid, are important for some women, especially if there’s a strong Osteoporosis hereditary factor.
I think the most important thing a woman can do as she approaches the Menopause is to educate herself about why and how her body is changing, because for me having information is always the most important tool in our toolbox. In my clinical practice I strive to give my patients as much information possible so they are better equipped to make the decisions that are right for them. In this blog I aim to do the same: give information so that you can make positive changes that are right for you.