Osteoporosis and Menopause: What to Know?

What’s the connection between osteoporosis and menopause? We know that osteoporosis, a condition that leads to weaker bones and a higher risk of fractures, affects four times more women than men. But is that a direct result of menopause?
This article was reviewed and fact-checked by Dr. Fionnuala Barton.

Dr. Fionnuala Barton is a GP, Women’s Health Doctor, and registered member of the British Menopause Society.

She is passionate about optimizing physical and emotional wellness for women at all stages of life and has a particular interest in early recognition and management of perimenopausal and menopausal symptoms, POI, PMS, and PMDD.

Dr. Barton is the founder of The Menopause Medic, an independent women’s hormone health clinic that aims to provide empathetic, holistic, personalized, proactive, evidence-based women’s hormone health consultations.

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Here, we’re exploring all the key facts about postmenopausal osteoporosis: what it is, how you treat it, and whether you can prevent it.

In this article: 📝

What is postmenopausal osteoporosis?

Osteoporosis is a condition where your body loses bone mass and doesn’t make enough new bone to replace it. The name osteoporosis means “porous bone”.

Think of your bones as having a hard outer shell with a sponge-like center. As osteoporosis develops, the “holes” in the “sponge” get bigger.

This leaves your bones much weaker and more prone to breaking than before.

We become more likely to develop osteoporosis as we get older.

Basically, we have our “peak” bone mass around age 30, and after that our bodies start to lose more bone than they make.

We’re left relying on the store of bone that we’ve built up during our younger years.

Often, osteoporosis is only diagnosed when it leads to a bone breaking or fracturing. Breaks are most likely in the wrist, hip, or spine, and they can have a serious impact on your mobility and your quality of life.

Both men and women can develop osteoporosis, but postmenopausal osteoporosis is a form of the condition that women develop after going through menopause (menopause is defined as the moment 12 months after your last period).

Most often, postmenopausal osteoporosis occurs 10 to 15 years after menopause.

How common is postmenopausal osteoporosis?

It’s estimated that around 54 million people in the US have osteoporosis or low bone mass (which could develop into osteoporosis), and the majority of these are women.

Postmenopausal osteoporosis is the most common type of osteoporosis.

And, sadly, research suggests that about one in two women who are age 50 or over will break a bone as a result of the condition.

What is the main cause of postmenopausal osteoporosis?

Scientists don’t know the exact cause of postmenopausal osteoporosis (or osteoporosis as a whole).

What they do know is that there is a clear link between postmenopausal osteoporosis and low estrogen levels.

As we saw above, bone loss starts in women at around the age of 30.

But before menopause, when your estrogen levels are still high, you lose bone mass fairly slowly.

After menopause, though, when your estrogen levels have dropped, bone starts to be lost at a much quicker rate. And it’s this that can lead to osteoporosis.

Going through early menopause and experiencing long periods with low estrogen (as a result of treatment for breast cancer, for example) also increase the risk of developing the condition.

What is the most effective treatment for postmenopausal osteoporosis?

Fortunately, there are a number of effective treatments for postmenopausal osteoporosis that your healthcare provider can prescribe.

First, though, you need to get a diagnosis.

Osteoporosis is diagnosed using a bone density test. It’s a kind of X-ray that takes about 10 to 20 minutes. Afterward, your bone density will be given a “T score”.

Here’s what the different scores mean:

• Above -1 SD: Normal
  
• Between -1 and -2.5 SD: Osteopenia (bone loss but not yet enough to count as osteoporosis)
  
• Below -2.5 SD: Osteoporosis

Postmenopausal osteoporosis treatment guidelines usually involve medications to slow down the rate of bone loss and strengthen your bones.

These are some of the treatments that your healthcare provider might suggest:

• Bisphosphonates, to slow bone loss and maintain your bone density. These can be used to help both treat and prevent osteoporosis.
  
• Raloxifene. This is one of a group of medicines called selective estrogen receptor modulators (SERMs). Essentially, it mimics the effect of estrogen on your bones, helping to maintain bone density and reduce the risk of fractures.
  
• Parathyroid hormone injection. This stimulates the cells responsible for creating new bone, so it can actually increase bone density. But this treatment is usually given only when your bone density is especially low and other treatments aren’t working.
  
• Calcium and vitamin D supplements. Calcium is the main mineral found in our bones, so taking extra calcium (on top of what you get from food) can help them stay healthy. Vitamin D helps your body to absorb calcium. It’s found mainly in sunlight, so if you don’t get out in the sun much, it can help to take a supplement.

The length of time you’ll receive postmenopausal osteoporosis treatment will depend on the type of medication and how severe your condition is.

If your healthcare provider thinks you have a high risk of breaking a bone, they’ll probably advise that you stick with treatment for several years.

Can you prevent postmenopausal osteoporosis?

Yes, the good news is that even if you’re already postmenopausal, there are plenty of things you can do to help strengthen your bones and reduce your risk of osteoporosis.

You might be able to make changes to your diet or lifestyle, or there might be medications you can take.

Here are some of the options:

• A high-calcium diet. Great sources of calcium to include in your diet are: canned fish that still have bones (such as salmon or sardines), dairy products, dark green leafy veggies (such as kale or broccoli), products fortified with calcium (such as juice or flour). You can also ask your healthcare provider about calcium supplements.
  
• Vitamin D supplements. If you don’t get a lot of sunlight (our main source of vitamin D) it might help to take a vitamin D supplement. Between the ages of 51 and 70, it’s recommended that you get 600 IU of vitamin D per day.
  
• Weight-bearing exercise. This is a type of exercise that makes your muscles work against gravity, which helps strengthen your bones. Try jogging, walking, playing tennis, or dancing three to four times a week.
  
• Bisphosphonates. As we mentioned above, this medication can slow bone loss, so it’s effective for helping to prevent osteoporosis as well as for treating it.
  
• Hormone replacement therapy. If you’re under 60 and/or less than 10 years postmenopause, hormone replacement therapy can help boost your estrogen levels and protect your bones. But, because it does come with health risks, it’s usually only prescribed if you’re experiencing other menopause symptoms as well.
  
• Managing existing medication. Some medications (such as steroids, blood thinners, some breast cancer treatments, and seizure medications) can increase your risk of developing osteoporosis. Talk to your healthcare provider about what you can do to help protect your bones if you’re taking one of these medications.
  
• Limiting alcohol and stopping smoking. Both alcohol and smoking have been linked to less healthy bones.

If you’re at all worried that you might be at risk of postmenopausal osteoporosis, the best thing to do is to book an appointment with your healthcare provider.

They’ll be able to advise you on the best steps you can take to reduce the risk.

And, if you need someone to chat to about all things menopause and postmenopause, the Peanut Menopause community is here for you.

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