Does The Menopause Cause Osteoporosis?

What Is Osteoporosis?

Osteoporosis is a bone condition that makes the bones weak and brittle. This makes the bones more likely to fracture and break. Osteoporosis develops slowly over a number of years.

Our bones are at their thickest and strongest when we are young adults. The loss of bone density is a normal part of aging though. It begins to decline gradually when are around 35 years old. This applies to both men and women. It’s less common for a man to develop osteoporosis than it is for a woman, but it does happen.

How Does Osteoporosis Affect Women

For women the drop in oestrogen levels affects bone density. Oestrogen is an important factor in healthy bones, so lowered levels during menopause can cause bone loss. This is particularly true of the first few years after reaching menopause itself, when bone loss can be quite rapid. The risk of osteoporosis rises for women whose menopause starts before they are 45 years old. Overall, osteoporosis is a common condition for women over 50 years of age.

Other factors

Other factors that can increase a woman’s chances of developing osteoporosis include:

• Excessive dieting
  
• Excessive exercising
  
• Bulimia
  
• Anorexia 
  
• Hysterectomy before age 45 (particularly if the ovaries were removed)
  

These can all cause periods to stop. For a woman whose periods stopped for more than 6 months due to any of the above reasons her risk of osteoporosis will be higher.

There are further factors that can increase your risk of developing osteoporosis. These factors can affect both men and women.

• Family history of osteoporosis 
  
• Low BMI (Body Mass Index)
  
• Excessive smoking or alcohol consumption
  
• Medications – long-term use of certain medications e.g some cancer treatments and some medicines used to treat Coeliac and Crohn’s disease.
  
• Corticosteroids (steroids) used long-term for asthma and arthritis for example
  

What Are The Symptoms Of Osteoporosis?

Osteoporosis develops slowly over the years. It can’t be seen or felt. You are unlikely to know that you have weakened bones until you experience a fracture or break, usually caused by a fall or sudden accidental impact.

What Are The Consequences of Osteoporosis?

The most common fractures experienced by people with osteoporosis usually occur in the wrist, hip and spine (vertebrae). In older people, fractures in the spine can make it difficult for the spine to support their bodyweight. This can lead to a stooped posture, as if the sufferer is bending forward.

Fractures can happen in other bones too. Pelvis, arms and ribs for example. It’s possible to cause a rib fracture just by coughing or sneezing if bone density is particularly low.

How Can I Prevent Osteoporosis?

You can help to prevent or lessen the effects of osteoporosis by making lifestyle changes, changes to your diet and exercise habits.

Oestrogen is important for healthy bones but oestrogen naturally decreases in women who are perimenopausal or have reached menopause and beyond. You don’t have any control over this. Calcium,Vitamin D and Magnesium are also important for bone health and the levels of these can be kept up through your diet and exercise regime. So this is something that you can take charge of.

Diet

By making changes to your diet you can maintain or improve your bone density. This will lessen your chance of fractures and breaks. You will also be improving your overall physical and mental wellbeing.

Calcium

Calcium is not only important for healthy bones but also for maintaining teeth and muscle health. On average adults need around 700 mg of calcium each day. Once you reach menopause however, you will need around 1,200 mg a day with 1,500 mg being the maximum amount. More than this can cause stomach pains and diarrhoea. 

These are a few of the calcium rich foods that you can include in your diet.

• Milk
  
• Cheese
  
• Yoghurt
  
• Tofu
  
• Soya beans
  
• Dried fruits
  
• Nuts 
  
• Pumkin
  
• Sweet potato
  
• Fish (where the bones are eaten) e.g sardines, pilchards, salmon (including tinned)
  
• Bread (if made with fortified flour)
  
• Pasta (if made with egg)
  
• Leafy green vegetables e.g broccoli, cabbage, okra, kale. (N.B spinach does contain a good level of calcium but also contains oxalates. The oxalates prevent the body from absorbing the calcium in spinach effectively. However, spinach contains lots of vitamins, minerals and antioxidants and is a good source of fibre. It’s definitely worth including it in your diet for these other benefits).
  

Vitamin D

Your body needs Vitamin D to be able to absorb and use the calcium that you eat as part of your diet. 

On average adults need 10 micrograms (mcg) daily. Your body will make most of your vitamin D through exposure to sunlight on your skin. You can also get vitamin D from your diet.

Foods that contain Vitamin D include:

• Tuna (fresh)
  
• Oily fish – salmon, mackerel, herring, sardines (oily fish also contain Omega-3 fatty acids which your body doesn’t make for itself)
  
• Red meat
  
• Egg yolks
  
• Some fortified breads and breakfast cereals
  
• Food supplements – it’s difficult to get the required amount of vitamin D from food alone so you may want to take a food supplement to top up your vitamin D levels. As a general guide a food supplement containing 10 mcg of vitamin D daily can be helpful, especially if it’s not easy for you to get outside on a regular basis.
  

Magnesium

Magnesium is also important for bone health. An adult woman needs around 270 mg per day. Fortunately, a lot of the foods that are good sources of calcium and vitamin D also contain magnesium. You should be able to get enough magnesium by eating a varied and healthy diet but some ‘multi’ food supplements also contain a small amount of magnesium.

Food Supplements

There’s no substitute for a healthy and varied diet for getting the nutrients that you need for a full, healthy and active life. However, none of us are perfect in our eating habits. Also some of us will have food allergies/intolerances or dietary choices that are important to us. Vegans, for example, choose to get their nutrition from non-animal sources. But no matter what your dietary restrictions or choices are you need to get the correct and adequate nutrients. 

Food supplements are a good way of topping these up and ensuring you get enough of what you need, even if you’ve had an off-day dietary wise. There are a lot of products available on the market but make sure you choose a trusted brand and always read the label.

Sunlight and Vitamin D

Sunlight is extremely important for the production of Vitamin D. While you can get some vitamin D from your diet exposing your skin to sunlight is the only way that your body can produce vitamin D for itself.

This may sound strange advice as it’s important to protect your skin from over-exposure to the sun. Protecting your skin from over-exposure to the sun is an important factor in preventing skin cancer. However, short, daily bursts of exposure are beneficial in allowing your body to make its own vitamin D supply and are unlikely to cause skin cancers.

You only need about 15 minutes at a time. Each day if possible or at least 3 times a week. You don’t have to strip off to benefit. Expose the skin on your forearms and hands or lower legs as a minimum. 

Take into account your skin colouring, how much skin you are exposing and the strength of the sun. Darker skin will take longer to make the same amount of vitamin D as lighter skin but lighter skin burns more easily. Don’t let your skin redden or burn. You don’t have to just stand or sit there if you don’t want to. If you prefer you can potter about in the garden or walk to your local shop for a newspaper. You’ll be increasing your exercise level that way too. Either way just let the sunlight and your body get on with the job of producing vitamin D.

It doesn’t have to be a hot sunny day for your body to do this. In the UK, getting out in the daylight regularly between late March and the end of September is beneficial. Particularly between 11 am and 3 pm.

If you’re planning to be out for longer then apply sunscreen, cover up, put on a hat and your sunglasses.

During the winter months in the UK the sunlight doesn’t contain enough UVB radiation for your body to make vitamin D. So during the winter months you will be relying on your diet and any food supplements you choose to add.

What Exercise Helps To Prevent Osteoporosis?

Exercise is just as important as diet in preventing osteoporosis and strengthening bones that have already been weakened.

Aerobic exercise such as cycling and swimming are good for your overall health, but there are 2 types of exercise that are particularly good for your bone health. Weight-Bearing and Resistance exercise.

What is Weight-Bearing Exercise?

Weight-Bearing Exercise may sound like you’ve got to become a weightlifter to get the benefit. Fortunately, the term doesn’t mean ‘pumping iron’ (which will probably come as a relief to most of us!).

Weight-bearing exercise is physical activity where your feet and legs support your body weight.

Examples of weight-bearing exercise are:

• Brisk walking
• Running
• Dancing
• Skipping
• Gardening
• Tennis
• Aerobics classes/exercises
• Tai Chi
• Even jumping up and down on the spot is a weight-bearing exercise

All of the above types of physical activity will help to strengthen your joints,muscles and ligaments and are good for your bone health.

What is Resistance Exercise?

Resistance Exercise helps to improve and maintain your muscle strength. Pushing, pulling and lifting are beneficial for both your muscles and bones.

Examples of Resistance Exercise are:

• Press-ups – you can do these upright against a wall if you prefer. They help to strengthen your wrists, shoulders and back.
• Lifting weights – you don’t need to be a weightlifter for this. Light weights such as hand-held dumbbells will produce the resistance that you need. You can also use other weight equipment at a gym or even tins of beans at home.
• Stretchy resistance band – you can usually buy these in sports shops or online, often with a workout DVD. They increase the resistance as you exercise.
• Yoga and Pilates are also a good way to improve muscle strength and flexibility. You can join a class or buy a DVD and do it at home.

Note of caution: If you haven’t exercised for some time start off slowly and build up as you feel fitter and stronger. If you have been diagnosed with osteoporosis, or have any other medical condition, ask your doctor before you start for advice on what exercise regime is suitable for you.

How Is Osteoporosis diagnosed?

A diagnosis will be carried out by your doctor or specialist. To reach a diagnosis an online assessment tool is used and also a bone density scan (DXA scan). The scan is painless and is similar to being X-rayed. Your medical and family history will also be taken into account in reaching a diagnosis.

Osteopenia

Osteopenia is a bone condition that means the bones have decreased in density, but the density is above the levels of osteoporosis. If you are diagnosed with osteopenia rather than osteoporosis your doctor may still recommend some osteoporosis treatment. This will depend on your test results and the risk you have of fracture.

How Is Osteoporosis Treated?

Treatment of osteoporosis will be based firstly on treating any fractures that you already have, then future prevention and bone strengthening.

Your risk of fracture will determine whether you need treatment or not. If you need treatment your doctor or specialist will discuss the most effective and safest plan for your treatment. Lifestyle changes, such as diet, exercise, smoking and alcohol consumption are likely to be part of your treatment plan.

How Can I Reduce My Risk Of A Fall?

Falls and knocks are a common cause of fractures if you have osteoporosis. You can help reduce your risk of further fractures by making a few adjustments.

Here are a few tips that may help.

• If you wear glasses make sure they are the correct prescription. Get your eyes tested regularly. Don’t walk around wearing your glasses if they are only for reading/close up. They will distort your distance vision and make you more likely to trip and fall.
  
• Make sure that the lighting in your home is bright enough. Particularly in hallways and above the stairs. If you tend to go to the toilet during the night make sure the lighting is adequate. We’re all a bit wobbly when we’re still half asleep.
  
• Slippers are comfy and relaxing for your feet but make sure they’re the sort that enclose your feet and are secure. ‘Flip floppy’ slippers are a trip hazard especially on the stairs.
  
• Common trip hazards are rugs and carpets. Make sure rugs don’t have any curling edges. You can buy rug grippers to go underneath to stop them slipping. Curling rug or carpet edges can be secured by double-sided carpet tape. It’s not expensive and is widely available.
  
• Clear pathways are important for your safety. Make sure your furniture is arranged so that you have clear, uncluttered pathways all around your home. It’s important to have a clear pathway to the bathroom if you tend to get up to go to the toilet at night.
  
• Don’t leave items on the stairs. Stairs should be kept clear. It’s easy to forget that you put something there meaning to move it later.
  
• Wires/flexes shouldn’t trail across the floor. They are likely to trip you up. Make sure all wires are tidy and tucked out of harm’s way.
  
• Sturdy, flat shoes may sound like a boring tip and a less attractive option than your heels. But when you think about how uneven pavements generally are, flat shoes really are the best choice. Uneven paving slabs, tree roots and debris all pose a trip hazard whatever your age or ability. There are lots of smart attractive flat shoe styles available. Why not treat yourself to a new pair.