Menopause and osteoporosis

Menopause is the time of your final period. As you approach it, your reproductive hormones — including oestrogen — fall. This drop in oestrogen affects many parts of the body, including your bones.

What is menopause?#

Most women reach menopause between the ages of 45 and 55, with the average being around 51 to 52. Menopause is confirmed once you have gone 12 months without a period.

How menopause affects bone health#

Bone density (thickness) starts to decrease as oestrogen levels fall in the lead-up to menopause, and it continues to decrease afterwards. Lower oestrogen increases the risk of developing osteoporosis — a condition in which the bones become less dense, so they break or fracture more easily.

On average, women lose up to 10% of their bone density in the first 5 years after menopause. About one in two women over the age of 60 will have at least one fracture due to osteoporosis.

Diagnosing osteoporosis#

If you have risk factors for osteoporosis, your doctor may refer you for a bone density scan called a DXA (or DEXA) scan. It measures bone density, usually around the lower spine and the upper part of the hip, and gives a T-score that shows whether you have:

• normal bone density
• some bone loss (osteopenia)
• a lot of bone loss (osteoporosis).

If you are diagnosed with osteoporosis, it is important to be treated and to have regular bone density assessments.

Reducing your risk of osteoporosis#

You can reduce your risk of developing osteoporosis by maintaining a healthy lifestyle.

Calcium and vitamin D#

Aim to eat about 1,300 mg of calcium every day. This is roughly 3 to 4 serves of dairy. Other good sources of calcium include firm tofu, almonds, Brazil nuts, dark green leafy vegetables, and fish with edible bones.

Vitamin D helps the body absorb calcium. It is made in the skin following sun exposure and is found in very small amounts in some foods. A simple blood test can measure your vitamin D level, and some people may need a vitamin D supplement.

Other lifestyle changes#

Try to reduce or stop:

• drinking alcohol
• drinking coffee
• smoking.

Exercise#

Exercise plays an important role in maintaining bone health. It also improves muscle strength, balance and fitness, and reduces the risk of falls and fractures. Aim for about 30 to 40 minutes of physical activity on most days of the week.

Some types of exercise particularly support bone health, including:

• weight-bearing exercises
• resistance training (for example, weight machines, dumbbells, push-ups and squats).

Seek advice from an accredited trainer, exercise physiologist or physiotherapist before starting a new program.

Menopausal hormone therapy and treatment#

Menopausal hormone therapy (MHT) started soon after menopause (around the age of 50) can help prevent bone loss. If you are diagnosed with osteoporosis, your doctor may also recommend certain medicines, or intravenous (IV) infusions and injections. Talk with your doctor about which options are right for you.

Key points#

• Falling oestrogen around menopause causes bone density to decrease, raising the risk of osteoporosis.
• Women lose up to 10% of their bone density in the first 5 years after menopause.
• A DXA scan and T-score are used to diagnose osteoporosis; if diagnosed, regular assessment and treatment are important.
• A healthy lifestyle — enough calcium and vitamin D, weight-bearing and resistance exercise, and reducing alcohol, coffee and smoking — helps protect your bones.

Where to get help#