Osteoporosis is the weakening of skeletal bones to the point that they break easily from mild trauma.
Healthy bones are composed of a spongy interior with small holes; the smaller the holes, the higher the bone density and the stronger the bones. As women age, however, the holes in their bones widen, sometimes leading to severely weakened bones that break easily.
The decline in estrogen during menopause contributes to the decrease in bone density, and this factor, combined with others, may lead to osteoporosis for some menopausal women.
Some other contributing factors include:
Race. Asian and white women tend to have lower bone density than women from other racial and ethnic backgrounds.
Hormones. Women who start their periods earlier and use estrogen-based contraceptives reach higher bone density compared to those who start periods later or do not use estrogen-based contraceptives.
Calcium intake. Deficiencies in calcium intake, especially in adolescence, can lead to lower peak bone density.
Weight-bearing exercise. Those who lift weights or regularly perform weight-bearing exercises, such as walking and aerobics, develop higher bone density and preserve it longer as they age.
To diagnose osteoporosis, your doctor measures your bone mineral density with dual-energy x-ray absorptiometry (DXA) imagery.
Bisphosphonates: This type of medication slows down bone loss to prevent fractures.
Raloxifene (Evista): This drug mimics the hormone estrogen in certain body areas to help prevent further bone loss and fractures.
Hormone Replacement Therapy: Estrogen therapy can help prevent further bone loss and fractures.
Teriparatide and Abaloparatide: These injectable drugs are hormones that increase bone density.
Denosumab: This type of antibody drug inhibits the body’s process of breaking down bones, reducing the risk of bone fractures.
Additions or changes to your lifestyle can support good bone health in menopause and beyond.
Exercise: Weight-bearing and resistance exercises keep your bones as strong as possible. These activities include: lighting weights, walking, dancing, gardening, and aerobics.
Calcium: Eating calcium builds and maintains strong bones. Dairy products, dark, leafy vegetables, white beans, canned salmon, and sardines are rich sources of calcium.
Vitamin D: This vitamin is critical in allowing your body to absorb calcium. Twenty minutes outside a day is enough for most people to get the amount of vitamin D they need, but you can also consume it through dairy products, fatty fish, eggs, or nutritional supplements.
Smoking: Quit or cut back on smoking as it can cause your body to produce less estrogen—leaving you more prone to osteoporosis.
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Estrogen deficiency is the primary cause of postmenopausal osteoporosis, according to the North American Menopause Society, and bone loss accelerates in late perimenopause and continues at a steadier pace in early menopause, according to a longitudinal study on almost 2000 multiethnic women.
However, Postmenopausal women who exercise are less likely to develop osteoporosis, according to one long-term study. Research also shows that body weight impacts bone mass, and underweight women tend to have lower bone mass than women who maintain a healthy weight.