By Dr Anna Alderton and Sally Sankovic
The recent Australasian Menopause Society (AMS) Congress really reinforced the message that bone loss begins in perimenopause. We reach our peak bone mass in our early 20s and it is then usually stable until our early 40’s. At this time, we start to lose a little bone density, but this accelerates rapidly from menopause. In fact you can lose 15-20% of your bone density in just the first five years after menopause!
Risk factors for osteoporosis include having a previous fracture, steroid medication use (usually longer-term use), having a parent who’s had a hip fracture, low body weight, smoking, excessive alcohol consumption, rheumatoid arthritis, and other secondary causes such as coeliac disease and premature menopause. These can result in lower peak bone mass and greater bone loss pre-menopausally.
Low body weight is a good predictor of low bone density, and low bone density at menopause increases the risk of fractures post menopause. We also know that the relative risk of hip fracture increases by 78% for women with moderate hot flushes.
MHT (Menopausal Hormone Therapy) may prevent fractures by maintaining, or increasing bone density. It also treats hot flushes REALLY well, and many other symptoms of menopause.
The great news is that there are also lifestyle changes we can make to prevent bone loss, and these include adequate dietary calcium, adequate sun exposure or vitamin D supplements to aid in calcium absorption, regular weight bearing exercise to enhance bone density, maintaining a healthy body weight (BMI 20-25), quitting smoking and limiting alcohol intake as they can weaken the bones.
Lifting weights can increase bone density!
The magnitude of the load on the bone needs to be very high to substantially overload the bone. This means lifting a weight that is so heavy that you can only lift it 4-6 times before it is too heavy to lift again (80-85% of the weight you could lift once only).
Bone is a USE IT OR LOSE IT tissue!
Weakened bones can increase susceptibility to fractures; the older you get, the greater your risk of a fracture if you fall over. 90% of hip fractures are caused by people falling over, and exercise reduces the risk of fractures as it reduces the risk of falls.
While many foods taste great, aim to eat more of the foods that help to prevent bone loss. Calcium strengthens bones, while vitamin D aids in its absorption. Magnesium, potassium, and vitamin K also contribute to bone health. As do leafy greens and fortified foods (food with nutrients added).
Also, please re-think that cigarette or glass of alcohol. Smoking and alcohol consumption also decrease bone strength.
Proactive measures including lifestyle adjustments can mitigate the risk of osteopenia and osteoporosis, ensuring a healthier, more active postmenopausal phase. Prioritising bone health during and after menopause is an investment in maintaining independence, mobility, and overall well-being.
Anna is a NZ trained GP, currently working in women’s health at the Gold Coast University Hospital. She graduated in Medicine from the University of Otago (NZ) in 2005, and since graduation has completed post graduate qualifications in Women’s Health and Child Health.
Prior to studying medicine Anna completed a Bachelor of Physical Education and a Post Graduate Diploma in Sports Medicine. She moved to Australia with her family in 2013. She has special interests in the management of heavy menstrual bleeding, vulval skin conditions, contraception, fertility, and menopause management. Anna also enjoys running, participating in ultra-marathons, and loves the outdoors, camping and hiking.
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