Navigating Menopause: Understanding and Managing Osteoporosis for Women’s Bone Health

Navigating Menopause: Understanding and Managing Osteoporosis for Women's Bone Health

Osteoporosis, hot flashes, weight gain, depression – these and more are the spectres of menopause. You can do nothing about menopause, but you can do a lot to counter almost all symptoms with a healthy diet and exercise. Additional hormones are not necessary. All women feel a certain uneasiness when they think about the approaching menopause. Those already in the middle of it struggle with very different problems and feel helplessly exposed to this profound phase of their lives. Read here what osteoporosis has to do with menopause and what helps against it.

What exactly is menopause?

The fact is that menopause, also known as the climacteric or menopause, is characterized by a permanent drop in hormone production (estrogen and progesterone ). This stage of life hits most women sometime between the ages of 45 and 50, or more extreme, between 40 and 55.

Of the 85 per cent of women who have any symptoms at all, 25 per cent suffer from severe menopausal symptoms. These include hot flashes, unstable moods and depression, less desire for sex, sleep disorders and headaches. Tiredness, cardiovascular problems, altered menstrual bleeding, drier skin or weight gain can also occur.


Osteoporosis in menopause

Another common side effect is decreased bone density – the dreaded osteoporosis. This occurs when the constant alternation between bone formation and bone resorption in the body is disturbed. This reduces the density of the bones, making them porous and more likely to break.

Osteoporosis is a common problem in menopausal women due to the lack of estrogen caused by menopause. Estrogen controls the absorption of calcium in the bones. Calcium, in turn, is central to the formation of bones, or the bone tissue that stabilizes them.

Remember, 99 per cent of the body’s total calcium content is stored in the bones. And it is understandable: When bone mass shrinks, the bone loses its stability. Painful broken bones, changes in the spine, and a hunchback (also known as the unflattering “widow’s hump”) are the consequences.

Additional hormones through hormone replacement therapy?

The hormone estrogen can be prescribed to counteract the symptoms that occur during menopause to correct the hormone level artificially. The so-called hormone replacement therapy, or HRT for short has been used since the 1960s to treat symptoms caused by a lack of estrogen.

As monotherapy or combination therapy (together with the corpus luteum hormone progestin), estrogens are used as medication during menopause in the form of gels, creams, patches or tablets.

Estrogens are not suitable for the treatment of an already existing, i.e. manifest, postmenopausal osteoporosis. They can only be used to prevent osteoporosis. But caution is also required here because long-term hormone replacement therapy, in particular, can increase the risk of breast cancer and diseases of the heart and vascular system. The possible side effects of hormone replacement therapy also depend on the age and any previous illnesses and family history of the person concerned. Therefore, the benefits of HRT should be weighed against the individual risks together with the doctor.

Hormone replacement therapy to prevent osteoporosis is usually only recommended if the affected person is already at increased risk of fractures and other medications cannot be taken due to intolerance or interactions with other medications.


Phytoestrogens as an alternative to hormone replacement therapy

The effect of so-called phytoestrogens in the treatment of postmenopausal osteoporosis has now been demonstrated in various studies. These botanicals, which include isoflavones and lignans, have estrogen-like effects. There are special soy-based preparations that can be taken as dietary supplements. In addition, phytoestrogens are contained in the following foods, for example:

The extent to which phytoestrogens can also be used to prevent the development of osteoporosis during menopause has not yet been sufficiently scientifically clarified. Seek medical advice about taking phytoestrogens via special supplements.

Other forms of treatment for postmenopausal osteoporosis

Another important group of active ingredients explicitly used for preventing and treating postmenopausal osteoporosis are Selective Estrogen Receptor Modulators, or SERMs for short. These inhibit the breakdown of bones and decrease the frequency of fractures. According to current knowledge, HRT has significantly fewer side effects than usual.

Special antibody preparations,  which are administered by injection twice a year, are also becoming increasingly popular in the treatment of osteoporosis during menopause. The antibody denosumab, in particular, can increase bone density and thus reduce the risk of fractures.

In addition, the drugs commonly used during osteoporosis treatment can be used. In addition to painkillers, these include calcium and vitamin D3 preparations and bisphosphonates, reducing bone fracture risk.

Prevent osteoporosis through diet and exercise.

With a few simple rules of conduct, you can help prevent the development of osteoporosis. This includes a balanced diet with plenty of calcium.

The basis for stable bones is created in childhood, but there is always time for a calcium-rich diet. The following foods contain a lot of calcium:

  • milk and milk products
  • sesame and nuts
  • Vegetables, such as broccoli, leeks, and kale (generally leafy greens)
  • whole grain products
  • parsley and dill

The calcium must be distributed throughout the day, for example, through several small milk meals or additional calcium supplements. It would help if you were careful not to take in too much phosphate, as found in processed cheese, sausage, and meat products. Phosphate impairs the absorption of calcium.

Besides the other positive effects on health during menopause, exercise is an excellent protection against osteoporosis. This not only strengthens the bones, but sport in the fresh air also promotes the formation of vitamin D, which in turn promotes the build-up of calcium in the bones. Tennis or walking, for example, are suitable.

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