Osteoporosis is a condition where bones become weak, brittle, and prone to fractures due to loss of density. Common fracture sites: hips, spine, and wrists. After menopause, declining oestrogen levels accelerate bone loss, increasing osteoporosis risk. It is often called a “silent disease” because bone loss occurs without symptoms until a fracture happens and 1 in 3 women over 50 will experience an osteoporotic fracture in their lifetime.
Why are post-menopausal women at risk?
- Oestrogen decline: Oestrogen protects bones; its reduction post-menopause speeds up bone breakdown.
- Age: Bone density peaks around age 30 and naturally declines with age.
- Other risk factors:
- Family history of osteoporosis.
- Low body weight or petite frame.
- Smoking, excessive alcohol, or sedentary lifestyle.
- Low calcium/vitamin D intake.
Diagnosis
- Bone Density Scan (DEXA scan):
- Measures bone mineral density (BMD) at the hip and spine.
- Results are given as a T-score:
- -1.0 to -2.5: Osteopenia (low bone mass).
- Below -2.5: Osteoporosis.
- FRAX Tool: Estimates your 10-year fracture risk using age, weight, and medical history.
Managing & preventing bone loss
Lifestyle Changes
- Nutrition:
- Calcium: Aim for 1,200 mg/day (dairy, leafy greens, fortified foods).
- Vitamin D: 800–1,000 IU/day (sunlight, fatty fish, supplements).
- Exercise:
- Weight-bearing activities: Walking, dancing, or stair climbing (30 mins/day).
- Strength training: Builds muscle to support bones (2–3x/week).
- Avoid smoking and limit alcohol to 1 drink/day.
Medical Treatments
- Bisphosphonates (e.g., alendronate): Slow bone breakdown.
- Hormone Replacement Therapy (HRT): May be prescribed short-term for severe menopausal symptoms and bone protection.
- Other options: Denosumab, teriparatide, or SERMs (raloxifene).
Fall Prevention
- Remove tripping hazards at home.
- Wear supportive shoes.
- Use assistive devices (e.g., cane) if unsteady.
Monitoring your bone health
- Regular DEXA scans: Every 1–2 years if diagnosed with osteoporosis/osteopenia.
- Blood tests: Check vitamin D, calcium, and kidney function.
eGynaecologist Advice
- You should seek gynaecological consultation about potential benefits and risks of hormone replacement therapy (HRT) after menopause.
- You should consider having regular bone density scans to monitor your bone health and discuss this with gynaecologist in your annual health check.
Frequently Asked Questions
Can osteoporosis be reversed?
While bone loss can’t be fully reversed, treatments can slow progression and reduce fracture risk.
Are supplements safe?
Calcium/vitamin D supplements are generally safe but consult your doctor to avoid over-supplementation.
Do medications have side effects?
Some (e.g., bisphosphonates) may cause heartburn or rare jawbone issues. Discuss risks/benefits with your doctor.
