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Management of Osteoporosis In Post-Menopausal Women

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Menopause, the natural ending of periods that usually occurs between the ages of 45 and 55, can increase the risk of osteoporosis, a condition in which bones become thin, less dense, and fracture easily. Increased bone loss is caused by the reduction in estrogen levels around menopause. In the first five years following menopause, women are thought to lose up to 10%-20% of their bone mass on average. According to research, osteoporosis will cause at least one fracture in one in two women over 60.

Any woman who is in the pre-menopausal stage can manage the risk for osteoporosis. Being a women, you can try some weight-bearing and resistance exercises and can adopt fall prevention strategies that are a part of a bone-healthy lifestyle. It is recommended to limit alcohol and intake of caffeine. Initiating calcium, vitamin D, phosphorus and protein-rich foods are the best dietary management for osteoporosis. 

THE IMPACT OF MENOPAUSE ON OSTEOPOROSIS

Around the age of 25 to 30, when the skeleton has stopped growing, and the bones are at their strongest and thickest, women reach their highest bone mass.

Estrogen, a hormone in women, is crucial for maintaining bone density. Estrogen levels fall around the time of menopause, which typically happens around age 50 and causes more bone loss. Any bone loss that occurs around menopause might lead to osteoporosis if your peak bone mass before menopause is less than optimal, which is 1.105 g/cm2 to 1.141 g/cm2, aged 50-54 years.

ENDOCRINE RELATIONSHIP

Osteoporosis, which translates to “porous bones,” is a chronic disorder where bones lose structural support and are more likely to shatter or fracture. Osteoporosis is most frequently brought on by menopause. Estrogen levels begin to fluctuate and then decrease due to hormonal adjustments to accommodate typical menopausal changes. Estrogen’s decline during menopause greatly accelerates bone loss since it slows bone’s normal breakdown, preventing bones from becoming weaker.

One of the three estrogen hormones that the body typically produces is estradiol. Women going through menopause can easily see the effects of estradiol. As the ovaries stop producing estradiol throughout this process, women naturally have decreased amounts of the hormone because the menstrual periods cease.

Other hormones that contribute to the health of bones include vitamin D and calcium. Your body can absorb calcium with the aid of vitamin D. Calcium is required for the development of robust, healthy bones. Without enough calcium and vitamin D, bones may not develop properly in childhood and lose bulk as they age, becoming brittle and susceptible to breaking. If you don’t receive enough vitamin D, your body won’t be able to absorb calcium from your diet, even if you consume adequate calcium.

MENOPAUSAL SYMPTOMS

This alteration frequently brings hot flashes, vaginal dryness, night sweats, and other menopausal-like symptoms. Osteoporosis can develop with time if estrogen levels are too low.

OSTEOPOROSIS SYMPTOMS

Osteoporosis is frequently referred to as a “silent illness” because the early stages of bone loss are asymptomatic. Before their bones become so fragile that sudden stress, jolt, or tumble results in a fracture or a vertebra collapse, people may not be aware that they have osteoporosis. Initial symptoms of collapsed vertebrae may include excruciating back pain, height loss, or spinal abnormalities like a bent posture.

REDUCING MENOPAUSE’S RISK OF OSTEOPOROSIS

You can lower your risk of acquiring osteoporosis around the time of menopause by adhering to a few lifestyle suggestions, such as:

  • Aim for a daily Calcium intake of 1,300 mg.
  • Three to four portions of dairy stuff are included in this.
  • Numerous non-dairy foods also contain calcium, including fish with edible bones, such as sardines or tinned salmon, firm tofu, almonds, brazil nuts, unhulled tahini, and calcium-fortified soy or almond beverages.
  • Engage in regular, suitable weight-bearing exercise, such as resistance training with weights.
  • Avoid high extensive exercises or other activities that call for quick, powerful movements.
  • Exercise involving weight, such as weight training, tai chi, dancing, and brisk walking.
  • Do aerobic activity for your body two to three times weekly.
  • Perform strength exercise (resistance) once or twice each week.
  • Include stretching or flexibility exercises in your routine.
  • Maintain healthy amounts of vitamin D. Calcium absorption by the body is aided by vitamin D.
  • Following sun exposure, it is produced in the skin, and some foods contain a level of vitamin D.
  • Limit your alcohol consumption: current guidelines recommend a maximum of two standard drinks per day with two alcohol-free days per week for women.
  • Don’t smoke: smoking cigarettes is associated with a higher risk of osteoporosis.
  • Limit your caffeine intake.

Nutrients Helpful in  Management of Osteoporosis

Dietary

sources of

Calcium

·         Green leafy vegetables including spinach, methi, mustard leaves, turnip greens

·         Fish with bones

·         Nuts and seeds like almonds, sesame seeds, flax-seeds  (High in calcium and omega-3 fats)

·         Quinoa (A light and healthy whole grain offering 60-100 mg of calcium in one cup)

Dietary

sources of

Vitamin D

·         Egg yolks

·         Liver

·         Saltwater fish

·         Salmon

·         Mackerel and tuna

Dietary

sources of

Protein

·         Meat

·         Seafood

·         Poultry

·         Eggs and dairy

·         Cheese and beans

Dietary

sources of

Phosphorus

 

·         Milk

·         Cheese

·         Yogurt

Agents with

vengeance

Agents with vengeance means that there are some things in diet that can interfere with how much calcium our body can absorb. These includes:

·         Phytic acid (found in: Unleavened bread, raw beans, seeds and grains)

·         Oxalic acid (found in spinach)

·         Sodium (Keep the sodium intake down as high levels of sodium interferes with calcium retention)

TREATMENT OF OSTEOPOROSIS

Depending on your age, the results of a bone density test, and your history of fractures, some therapies & medical treatments are recommended by a doctor.

The medical treatments for osteoporosis:

  • Selective estrogen receptor modulators (SERMS)
  • Bisphosphonates
  • Menopausal hormones therapy (MHT) or hormone replacement therapy (HRT)
  • Denosumab
  • Parathyroid hormone
  • Supplementation of calcium and vitamin D.

Supplement use in relation to bone health

Supplement

of focus

Findings

Protein

Protein supplementation has a small but positive effect on lumbar spine bone mineral density.

Vitamin D

Supplements of vitamin D prevent fractures in older people as formulated and tested. Calcium and vitamin D supplements collectively are required in preventing hip and any other type of fracture.

Vitamin D

Supplementations of vitamin D has further shown small benefits at the femoral neck but no effects were seen at the other sites.

Vitamin D

Oral vitamin D supplementation (700-800 IU/day) can reduce the risks of hip and non-verbal fractures in institutionalized elderly persons.

Calcium

Supplementation of calcium and dietary intake has shown small non-progressive increases in bone mineral density.

Vitamin K

Supplementation of vitamin K has shown positive results to increase bone mineral density at lumbar spine but not at the femoral neck.

Phosphate

 

There is no evidence found that the supplementation of phosphorus intake is related to the demineralization of bone or to excretion of calcium in the urine.

Recommended Questions

How can you treat pre-menopause and osteoporosis? Pre-menopause and osteoporosis can be treated by:

  • Combination oral contraceptives
  • Selective estrogen receptor modulators
  • Bisphosphonates
  • Teriparatide or PTH (1-34)

Which treatment is given to early osteoporosis in pre-menopausal women? Early treatment includes the initiation of bisphosphonates. It is the first choice treatment for osteoporosis. Bisphosphonates include alendronate (Fosamax) once in a week. Actonel can also be taken as a monthly pill.

How can women prevent the risk of osteoporosis in early menopause? The risk of osteoporosis during menopause can be reduced:

  • Initiating 1300 mg of dietary calcium intake, every day in diet.
  • Doing regular and appropriate weight-bearing physical activity, including the resistance training exercise with weights.

What do you mean by pre-menopausal osteoporosis? The chance of bone-thinning disease called as osteoporosis increase with the age in women especially after menopause. It is not an uncommon thing for women to get this condition before menopause and is called as pre-menopausal osteoporosis or bone loss.

Can a 40 years old women have osteoporosis? 40 Years old women can also get osteoporosis. It is more common in young people including the premenopausal women in their 20s, 30s and 40s.

Which is the best natural treatment for osteoporosis? The best natural treatment for osteoporosis includes:

  • Trying a vitamin-D supplement
  • Increasing the magnesium intake in diet
  • Tackling the stress
  • Making dietary changes
  • Avoiding sparkling juice and caffeine
  • Practicing some moderate exercise
Alnoor Naseem is a Nutritionist and Dietitian by profession and a writer by passion. Being a nutritionist, she loves to explore the science behind food and spread authentic knowledge so that people can clear their misconceptions regarding holistic nutrition and lifestyle.

She can be reached at [email protected]

Disclaimer: The information in this article is not intended as sound medical advice for your particular illness; rather, it is meant to increase awareness of common health issues. Before implementing any recommendations made in this article or choosing a treatment plan based on its contents, you should always speak with a qualified healthcare professional.

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7 replies on “Management of Osteoporosis In Post-Menopausal Women”

Good written by Dn Alnoor naseem. This issue in women normally ignored.Best knowledge for women ,girls and to be mothers women.

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