Osteoporosis is a condition that weakens bones, increasing the risk of a sudden and unexpected fracture. This results in an increased loss of bone mass and strength and the condition often develops without any symptoms or pain. Osteoporosis remains undiscovered until weakened bones cause painful fractures, usually in the back or hips. Menopause, as we know, marks the permanent end of menstruation and fertility, and most women start experiencing menopause between the age of 45 and 55 years.

As women enter the phase of menopause, their estrogen levels begin to fall. Estrogen acts as a shield of bone strength and its lack can contribute towards the development of osteoporosis. Early menopause (before the age of 45) and any extended periods in which hormone levels are low and menstrual periods are absent or infrequent can cause loss of bone mass. Women undergoing menopause have a higher risk of developing osteoporosis, but there are many ways to slow it down and strengthen the body against it.

Symptoms

There are no major symptoms in the early stages of bone loss. However, once the bones have been weakened by osteoporosis, one might experience symptoms that include:

• Back pain, caused by a fractured or collapsed vertebrae (small bones forming the backbone)
• Stooped posture
• Loss of height over time
• A bone that breaks more easily than expected

Understanding risk factors

Age --- The body creates more bones up to around the age of 30 years. After this, bone deterioration occurs faster than bone creation

Smoking --- Smoking has been shown to increase the risk for osteoporosis. It can also cause earlier onset of menopause, resulting in reduced protection for the bones

Body composition --- Women who are thin have a greater risk of developing osteoporosis compared to women who are heavier or have a larger body frame. This is because thinner women have less bone mass overall compared to women who are heavier

Existing bone density --- When women reach menopause, the greater the bone density, the lower will be the chance of developing osteoporosis

Family history --- If a woman’s parents or grandparents had osteoporosis or a fractured hip because of a minor fall, they might also be at a risk for developing osteoporosis

Management options

Taking calcium and vitamin D supplements – Calcium can help build strong bones and keep them strong as one age. Women over 50 are recommended to get at least 1,200 mg of calcium each day.There is enough calcium in dairy products, kale, and broccoli. However, additional supplements like calcium carbonate and calcium citrate deliver good forms of calcium to the body.

Medications and injectable bone-building agents – A group of drugs called bisphosphonates helps prevent bone loss. These medicines have shown to slow bone loss, increase bone density, and reduce the risk of bone fractures.

Regular weight-bearing exercise --– Daily exercise does as much for building and maintaining strong bones as medication does. This makes bones stronger and helps prevent bone loss.

Walking, jogging, dancing, and aerobics are all good forms of weight-bearing exercises.

Hormone Therapy - Hormone therapy is considered useful in preventing or easing the increased rate of bone loss that leads to osteoporosis. It is best to talk to the doctor so one can weigh the benefits of hormone therapy or consider other treatment for the bones.

(The author is associated with the department of obstetrics & gynaecology, CK Birla Hospital, Gurgaon. Views expressed are personal and do not necessarily reflect those of Outlook Magazine.)