Women with early menopause have a 56 per cent increased risk of osteoporosis in their 70s

Various reasons of early menopause can be genetic

Women with menopause before the age of 47 have more than 50 per cent increased risk of osteoporosis in their late 70s as compared to a risk of 30 per cent in women with late menopause.

A 2020 study published in ‘Human Reproduction’ claims that women who undergo premature menopause are almost three times more likely to develop multiple, chronic medical problems including diabetes, high blood pressure, heart disease, stroke, arthritis, osteoporosis, asthma, depression, anxiety or breast cancer.

It has been observed that during the menopausal transition period (perimenopause), the average reduction in bone mineral density (BMD) is about 10 per cent. According to Dr Meenakshi Banerjee, Senior Consultant – Obstetrics and Gynaecology, Madhukar Rainbow Children’s Hospital, Delhi, about 25 per cent of postmenopausal women can be classified as fast bone losers and this can be increased by various other factors like genetic influence, medicine effects like steroids, antiestrogen medications, low exercise and activity among others.

Various reasons for early menopause can be genetic. According to Dr Neha Khandelwal, Senior Consultant – Obstetrics and Gynaecology, Madhukar Rainbow Children’s Hospital, Delhi, even premature ovarian failure, in which ovaries which are responsible for producing female hormones fails to produce adequate hormones, leads to early menopause. Removal of ovaries due to any pathology, malignancy can cause early menopause.

Osteoporosis is also termed as a ‘silent disease’ as its effects are not seen in the early stages. Women are four times more affected by early bone loss as compared to the men. Estrogen, which is a primary female hormone, is responsible for bone health. After menopause and in the transition period (perimenopause) there is an increased bone loss due to decreasing estrogen levels hence making the women more prone for osteoporosis, said Dr Banerjee.

Hormonal Therapy: A saving grace 

To reduce the loss of bone and other postmenopausal symptoms like vaginal dryness and hot flushes, hormone replacement therapy in form of estrogen is beneficial. But their use should be done with utmost caution after screening the women whether she will be best benefited with this therapy.

Dr Khanadelwal added, “Hormonal therapy can be taken in the form of tablets, skin patches, estrogen gel and implants. Cyclical HRT can be taken with daily estrogen and progesterone alongside for the last 14 days of the cycle. This is for women with menopausal symptoms. Whereas, for postmenopausal women continuous combined HRT should be considered without breaks.”

The other factors affecting estrogen levels can also be related to women being on anti estrogen medications (given in breast cancer treatment), women who are on steroid medications for more than three months.

Exercise, sunshine, and diet: Preventive and curative solutions

Reduced exercise, activity, increased smoking and alcohol, low BMI make a woman more susceptible to osteoporosis. Over a period, your bones become weak if you have poor lifestyle choices such as smoking, drinking alcohol or eating junk food. Adopting an ayurvedic lifestyle coupled with adding fresh fruit and herbs in your daily diet can help to overcome the disorder.

“Walking and gentle aerobics are excellent for bone health because they promote the entry of calcium into the bone mass where it is used for improved strength and growth. A healthy and balanced diet is fundamental to bone (and general) health because it supplies the protein, carbohydrate and fat, vitamins, minerals and other nutrients vital for tissue renewal and growth,” advised Dr Banerjee.

Fresh fruit and vegetables supply a vast range of essential minerals and other nutrients needed to maintain a sturdy skeleton. Your diet should also include dairy foods and foods rich in calcium, like green leafy vegetables, spring greens, spinach and broccoli, baked beans, nuts (almonds), soya beans, sardines, salmon, nuts, dried beans, and sunflower seeds.

Vitamin D is also essential because it enables calcium and phosphorus to be used to form strong bones and teeth. It can be obtained from sunshine and as a supplement. Such patients should expose their body to sunlight for 20 minutes/day from May to October. It can also be obtained from food, e.g. milk and dairy products, fish liver oils, sardines, herring, salmon, and tuna.

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