This month sees both World Menopause Day (18th) and Osteoporosis Day (20th)
As a chiropractor I deal a lot with bones and also with people, mainly women, who have osteoporosis. Men also get osteoporosis, but it tends to affect them less as they age, due to the greater bone density that men have to start with.
When women go through menopause, it brings changes that can significantly affect bone health. The decline in oestrogen, during and after menopause, accelerates bone loss, which raises the risk of osteoporosis and fractures. Often it is not diagnosed until somebody has a fall and fractures a bone, which typically means you have had osteoporosis or osteopenia (less severe) for a while. This is why it is often called a silent disease.
The problem is that once bone density has decreased there are currently few first line medications to rebuild bone that are actively provided by the NHS. However this year abaloparatide, a new medication is available on NHS for post menopausal women. Unlike, the current medications which stabilise or slow loss at best, abaloparatide stimulates new bone growth. HRT can also help reduce the risk of osteoporosis from menopause.
By being proactive, women can navigate menopause with greater confidence and safeguard their bone health for years to come. This is why I always suggest women over 60 or those with a family history, early menopause or with some gastrointestinal conditions see their GP and discuss getting a DXA scan to get a baseline Bone Density Measurement. You might also ask for a vitamin D blood test since around 50% of the UK population are deficient. If the bone density is fine, then actions can be implemented to help protect yourself and if not, your GP can put treatment in place to prevent it worsening. You may be given a FRAX calculation, but this does not in itself check your bone density. FRAX simply estimates your chance of a fracture in the next 10 years and for an accurate result it needs a bone density measure. A new technology is the REMS scan (radiofrequency echographic multispectrometry) which uses ultrasound and provides more detail as well as a fracture risk. Currently this is only available privately.
There are steps women can take to protect their bones, like eating a balanced diet rich in calcium and vitamin D (possibly take supplements), engaging in regular weight-bearing and muscle-strengthening exercise, and maintaining a healthy lifestyle. All contribute to stronger bones. Avoiding smoking and excessive alcohol also helps.
This is just a basic introduction and if you have any questions, feel free to contact me, the pharmacist or talk to your GP. For more information here is a link to the Royal Osteoporosis Society https://theros.org.uk/information-and-support/osteoporosis/
