Bone health often declines for women during and after menopause, resulting in an increased risk of fractures. There are ways to reduce that risk, however, with lifestyle changes and the help of health care providers.
Sanford Health’s Bailey Hanson is a physician assistant who practices in internal medicine and offers a variety of women’s health services at Sanford Southpointe Clinic in Fargo, North Dakota.
Those services include treating osteoporosis, a disease that weakens bones and affects half of all women over the age of 50, according to the National Osteoporosis Foundation.
We recently asked Hanson to address common questions involving menopause, bone loss and the onset of osteoporosis.
How does menopause influence osteoporosis?
Menopause significantly impacts bone health for women. Throughout the menopause transition, women can lose up to 20% of their bone density. Bone is such a dynamic tissue – our bodies are constantly breaking down old bone and building new bone.
Before menopause, estrogen helps to keep this balanced. Without estrogen after menopause the rate at which the bone breaks down exceeds the rate at which the bone is rebuilt. This places women at much higher risk for fractures compared to men. Nearly 75% of all hip fractures occur in women.
How can you reduce the risk of osteoporosis after menopause?
Women can help manage bone loss after menopause with weight-bearing exercises. This could include activities like yoga, tai chi or a brisk walk. Making sure intake of calcium and vitamin D is sufficient can also help. Recommended is 1,200 mg of calcium daily from diet alone. An 800-2,000 IU (international unit) of vitamin D3 is typically also recommended.
Alcohol, smoking, and long-term steroid use can all increase the risk of osteoporosis. It is important to refrain from smoking and avoid excessive alcohol use. Make sure if you are taking oral steroids that it is medically necessary and your bone health is being closely monitored.
When is it time to speak to your provider?
It is important to speak to your primary care provider at age 65 to get your first baseline DEXA (bone density) scan. If you have a history of chronic steroid use, are a smoker, have a history of alcoholism, or had a fracture from a fall from standing height or less after menopause, I would recommend speaking to your primary care provider about a DEXA scan as early as age 55.
It is important to remember that osteoporosis is a disease and causes significant consequences if not properly treated. Speaking to your provider about bone health needs to be a priority long before your first fracture.
What are some treatment options for osteoporosis?
We have several options. They include oral medications called bisphosphonates, as well as an IV version of a bisphosphonate. A twice-a-year injection called denosumab is also an option.
There are some known side effects from osteoporosis medications, such as jaw issues or esophageal irritation, but often the benefit of these medications far outweighs the risk of side effects.
Your provider can have a risk-vs.-benefit discussion with you to find the safest and most effective option for treatment.
Schedule an appointment with your primary care provider today.
Learn more
- A foundation for strong bones
- What to expect through the stages of menopause
- Strength training at home: More than weightlifting
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Posted In Healthy Living, Internal Medicine, Menopause Care, Women's
