Shanti was 55 years old when she sustained her first wrist fracture after falling off a two-wheeler in a minor accident. At the time, doctors suspected nothing more to be wrong with her and she was treated for the fracture alone. However, months later, she slipped and fell in the bathroom, and sustained another fracture which proved to be more serious, and led doctors to discover an underlying issue.
Medical investigations led doctors to conclude that Shanti had extremely low bone density, which was making her more prone to sustaining fractures from even minor impact injuries. She isn’t alone. Each year scores of women are treated for fractures, while many of them brush off injuries as related to “old age”, doctors state that post-menopausal women are at particular risk of osteoporosis.
Why are women at higher risk of osteoporosis during menopause?
Osteoporosis is a term which literally means “porous” bone. As the name suggests, it is a result of loss of bone density as a result of which the bones become brittle and fragile, putting them at risk of fracturing easily. Many women may develop osteoporosis around menopause, for which certain precautionary measures should be taken.
“Many women begin to lose bone density as they approach menopause. This happens as a result of the depletion of oestrogen,” explains Dr Suhasini Inamdar, a consultant obstetrician and gynaecologist with Motherhood Hospital in Indiranagar, Bengaluru.
Throughout life, bone cells called osteoclasts are working to break down bone tissue to release the minerals from the bones (such as calcium) into the blood for use by the body in a process called resorption. While osteoclasts break down older cells, osteoblasts aid in forming new bone cells to maintain bone density. Oestrogen plays an important role in ensuring that bone density is maintained by reducing resorption, until the body deems it necessary.
Several studies have shown that lack of oestrogen results in an increase in the rates of bone resorption.
“With menopause comes a significant change in the hormones, including oestrogen. So with less oestrogen available, the resorption process isn’t regulated properly and women wind up with weaker bones,” explains Dr Suhasini.
How can menopause-related osteoporosis be managed?
Doctors recommend that women over the age of 45 get regular screening for vitamin D, calcium, and bone density, regardless of whether they have reached menopause or not. For women who have attained menopause, it is required that they take calcium and vitamin D supplements regardless of whether they are currently showing any signs of bone fragility or not.
“Many times people assume that they do not need supplements unless there is any indication for them, however, this is inaccurate. It is a good idea to provide supplementation through food that is rich in calcium, however our diet may not be enough to provide the levels of calcium we need. A woman in her 40s should be taking 1.5 grams of calcium in a day,” adds Dr Suhasini.
What can happen if osteoporosis goes undetected? According to Dr Krishnan M, an orthopedician from Bengaluru, someone with osteoporosis is at risk of developing fractures due to physical injuries. Areas such as the spine or the head of the thigh bone (femur) are the areas that are most commonly prone to fractures.
“Women can also be given hormone therapy during or after menopause if needed to supplement the reduced oestrogen production which will help to keep bone density at the required levels,” he explains.