Osteoporosis and Menopause
Another risk associated with the menopause is osteoporosis. In this article Audrey Redmond, physiotherapist, advises us that it's known as the silent disease - it comes without warning, there are no symptoms, no niggles and no signs that your bone structure is changing and becoming more porous. This leaves your bones weaker and increases your risk of sudden and unexpected fractures.
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Menopause and Osteoporosis
Awareness of the risk empowers you to think proactively about preventing, monitoring and/or managing the disease.
How is osteoporosis linked to menopause?
The hormone Oestrogen plays an important role in maintaining bone strength. After menopause the levels drop and this accelerates the process of bone resorption (breakdown). This breakdown happens faster than the body can rebuild new bone and the result is a weaker skeleton making you prone to breaking a bone more easily.
Peak bone mass – did I have strong bones to start with?
Your bones are strongest (at their peak) between the age of 20-30 years. During this time your body is building more bone than breaking it down (resorption). After the age of 35 we enter the phase of gradual loss of bone mass. Lifestyle choices and diet can positively contribute to your future bone health. Starting out with higher peak bone mass reduces your risk of osteoporosis later in life.
We should encourage all teenagers and young woman who still have the opportunity to build denser, stronger bones to be proactive in achieving peak bone mass and maintaining it. The recipe is simple - get enough Calcium and Vit D, stick to a balanced diet, exercise and don’t smoke or drink.
How can I prevent osteoporosis?
Exercise – Exercise makes bones and muscles stronger and helps prevent bone loss. Weight bearing exercises (exercises that make your muscles work against gravity) are best for prevention and should be done 3-4 X per week, for 30 minutes. This could include playing tennis, walking, running, dancing and many more. Balance – It is important to include balance exercises which may help prevent a fall and reducing your chance of breaking a bone. Additionally, good postural awareness, flexibility and resistance (strength) training can assist you to exercise in a safe and enjoyable way for many years to come.
Nutrition – Eat foods high in calcium. Milk and dairy products are commonly known as rich in Calcium but there are many other food sources that should be included in our diet. Vitamin D is used in our bodies to absorb calcium. Ensure you see the sun and eat foods that are high in Vitamin D. Should you be unable to take enough of the above then a Nutritionist can advise on supplements.
Other - Limit alcohol consumption, don’t smoke. Steroids and certain medications can increase rate of bone loss and your awareness of this enables you to compensate through other means. Be advised by your Doctor.
What causes osteoporosis?
We don’t know the exact cause of osteoporosis but we do know how the disease progresses. Your bone tissue has a trabecular structure (sponge-like) and as the disease progresses the holes within the structure grow larger and therefore the bones get weaker.
How can I monitor if I have osteoporosis?
Usually there is no sign that osteoporosis is developing until a fracture occurs. Fractures are most common in the spine, hip and wrist and can occur after only a minor fall.
Osteoporotic fractures of the spine causes loss of height and a gradual development of a rounded and stooped appearance, you may even notice a gradual loss of height. These fractures may or may not cause pain.
Know the risk factors
Some are more at risk – this does not mean you will get osteoporosis, just that it increases your chances. The risk factors to consider are:
- Family history of osteoporosis
- Ethnicity – Caucasian and Asian woman are more likely to develop osteoporosis, African women are relatively immune.
- Your periods stopped for over 6 months when you were younger
- You had anorexia
- You went through menopause before the age of 45
- You are (or were) a smoker
- You take medication like steroids, heparin, anti-convulsants, diuretics and long-term laxatives , thyroid medication
- You are inactive
- Slim build
- Digestive problems such as Chrohn’s or coeliac
- You drink more than seven units of alcohol per week
- You have more than 2 cups of coffee or regular tea per day
- Gender – females are 4 times more likely to get osteoporosis
Diagnosing osteoporosis – DXA scan
If you have any of the risk factors above and are going through the menopause it is important to check your bone health by having a DXA scan – this is an easy and painless test that can be organised through your GP.
A DXA scan looks at the density of your bone in your hip and spine and will give you the diagnosis of normal bone health, Osteopenia (early stages of osteoporosis) or osteoporosis. The outcome of this test usually determines what your next course of action is but more importantly gives you a base-line reading from which you can monitor future bone health.
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Other tests to help monitor bone health:
- Ultra sound – Sound waves are passed through your heel bone to measure factors related to bone quality.
- Bone turnover – A urine test which shows rate of bone resorption.
- Hair mineral analysis test – this test assesses deficiencies in the main minerals (calcium, magnesium and zinc)
- These and other tests are available but in Ireland the most commonly used diagnostic test is the DXA scan.
Understanding your DXA scan readings
The DXA test results are presented as a T-score and a Z-score. The T-score compares your reading with the bone density of a young woman (when peak bone mass is at its best) and the Z-score compares your reading with woman of the same age as you.
- A T-score more than -1 indicates normal bone density
- A T-score between than -1 and -2.5 indicates low bone density (osteopenia)
- A T- score of -2.5 and less indicates osteoporosis.
Meet Audrey Redmond of Physiofusion
Audrey graduated in 1998 with First Class Honours from the University of Pretoria, South Africa. Shortly after graduation she moved to London where she remained for 8 years gaining valuable experience in treating sporting and other injuries.
Audrey worked in Stoke Mandeville Hospital, the National Centre of Spinal Cord Injuries in the UK, as a Senior Physiotherapist and completed her time in London managing the Physiotherapy and Hydrotherapy Department at the well-known King Edwards VII Hospital Sister Agnes where the focus was on the speedy rehabilitation of joint replacements and sporting injuries.
Since then Audrey has gained further certification in Pilates training from beginners through to advanced level and prenatal and postnatal instruction. Through undertaking a number of courses in Pilates her teaching style, using small equipment, is innovative and challenging.
Audrey, a member of the National Osteoporosis Society of the UK, is actively raising awareness of Osteoporosis and is an advocate of the benefits of safe exercise as a preventative measure. She runs twice weekly Osteoporosis classes and is best placed to manage musculoskeletal problems with this condition.
To make an appointment with Audrey please email firstname.lastname@example.org or call (01) 607 7104.