Osteoporosis is a common physical symptom in women of menopausal age. It’s known as the “silent disease” – often you won’t know you have it until, suddenly, you break a bone. If you get to this point of bone fragility, you probably already have osteoporosis, and with that comes an increased risk of further fractures and the associated complications that can arise from these. The process of bone decalcification starts long before you become aware of it, so prevention is undoubtedly the best way to deal with it.
Osteoporosis is aggravated by a lack of oestrogen, which causes your bones to lose density over time. It evolves in stages. Before full-blown osteoporosis, you will develop osteopenia; if you catch the condition at this point, you still have time to adjust your lifestyle and start treatment to prevent it from worsening.
What causes osteoporosis?
Osteoporosis literally means “porous bone”. Losing bone density is a normal physiological part of ageing, but in some people it can happen much faster than normal, which may lead to an increased risk of fractures. Oestrogen is essential for maintaining bone density.
The process of bone maintenance and formation involves two different types of cells: osteoblasts and osteoclasts. Osteoclasts (bone resorbing cells, which break down the tissue in bones and release the minerals, resulting in a transfer of calcium from bone tissue to blood) and osteoblasts (bone forming cells) make up a multicellular unit, co-ordinating to regulate the balance of bone resorption and formation. This process is also regulated by several hormones, including the parathyroid hormone (PTH), calcitonin and oestrogen.
Oestrogen affects bone in several ways:
1) It lowers the sensitivity of bone mass to PTH, thus reducing bone resorption.
2) It increases the production of calcitonin, thus inhibiting bone resorption.
3) It accelerates calcium resorption by the intestine.
4) It reduces calcium excretion from the kidneys.
5) Oestrogen can also have a direct effect on bone. Oestrogen receptors are present in bone tissue, and with the significant drop in oestrogen that comes with menopause, there is a rapid decrease in bone density. At this point, bone loss becomes faster than bone growth. If not addressed, the lack of oestrogen can leave bones brittle and porous, and lead to osteoporosis. Women are at greater risk than men, particularly if menopause begins before the age of 45.
Discuss your risk factors with your GP – but there are also a number of things you can do to try and keep your bones as healthy as possible.
You can prevent the onset of osteoporosis. First, get a Dexa scan to assess your bone health (Dexa stands for dual energy x-ray absorptiometry – basically it’s an x-ray that measures bone density). Your GP can refer you, though the NHS waiting list is long. There are also a number of private companies that offer this service in the UK; the current cost is about £65. Think about getting a Dexa scan around the onset of menopause: you may have osteopenia already and, at this stage, you can still do something to tackle it.
So what practical steps can you take to prevent osteoporosis?
Hormone replacement therapy (HRT) can be effective in osteoporosis prevention, because it partially restores oestrogen levels, and so slows down the process described above. Not every woman can take HRT, but there are many other ways to improve your bone health.
Every child knows that calcium is good for bone health, and it becomes even more important as we get older. While milk and dairy products are a great source of calcium, there are other ways to take it, particularly if you are lactose-intolerant or vegan. Consider upping your intake of leafy green vegetables such as kale and broccoli, or drink calcium-fortified orange juice. Otherwise, take a daily calcium supplement. Alternatively, you can use a wide-range supplement such as Meno Blend (available here at a discounted price); as well as vitamins necessary for menopausal women, it also contains superfoods. Vitamin D
Calcium is only the first step. Vitamin D helps your body to absorb calcium, so to reap the necessary benefits and strengthen your bones, you need a daily dose of both. Sunlight is an excellent source of vitamin D, but living in the UK we just don’t get enough, so up your intake of oily fish, dairy or, failing that, vitamin D-fortified foods or supplements.
Exercise isn’t just great for your muscles and your general fitness, but also for your bones. Good old-fashioned weight-bearing exercises such as light weightlifting or Pilates are great for healthy bones. And “weight-bearing” doesn’t necessarily mean adding weights to your exercise routine: your own body weight is enough to work with.
Avoid alcohol and smoking
Alcohol can damage your bones, and smoking can decrease your oestrogen levels – try to avoid both if possible, or at least cut down.
For more information, visit the Royal Osteoporosis Society’s website at theros.org.uk