Menopause and bone health; a growing global health concern

  • Worldwide more than 200 million women are estimated to have osteoporosis and 1 in 3 women over age 50 will experience osteoporosis fractures.
  • Poor bone health is increasing as populations age.
  • The International Menopause Society has published a new report to highlight concerns on World Menopause Day. 

The International Menopause Society (IMS) has published a new report for World Menopause Day which shows that one of the most important emerging health issues for midlife women is bone health.

The ‘Update on bone health’ report, carried out by world-leading experts in the field of menopausal health, highlights the growing issue of poor bone health in menopausal and post-menopausal women. 

Particular issues identified in the report are osteoporosis, sarcopenia and osteosarcopenia. These conditions are especially prevalent in women.[1]

Most women will go through the menopause between the ages of 45 and 55 and they will often lose bone rapidly during this time. Worldwide more than 200 million women are estimated to have osteoporosis and, as populations continue to age, the problem is getting worse. [2] The IMS report highlights that the condition represents a major global health problem and fractures associated with osteoporosis reduce quality of life and increase the chances of disability and premature death.[3]

After a woman’s last menstrual period, their ovaries stop the production of the hormone oestrogen, this leads to decreased bone strength. Osteoporosis develops slowly and is diagnosed when bone health deteriorates to such an extent that small impacts are likely to cause them to fracture. Worldwide, 1 in 3 women over age 50 will experience osteoporosis fractures.[4]

Risk factors for osteoporosis include a recent fracture or a family history of hip fracture, low body mass index, rheumatoid arthritis, type 1 diabetes, early menopause, smoking, abuse of alcohol and a sedentary lifestyle. 

Sarcopenia is a newer concept that incorporates the inevitable loss of muscle mass, muscle strength and performance as people age. IMS researchers highlight that the role of muscle strength and function in maintaining bone health should not be overlooked and that when sarcopenia exists as well as osteoporosis (Osteosarcopenia) the risk of bone fractures is greatly increased.  

Steven R. Goldstein, MD, professor of Obstetrics and Gynecology at NYU Grossman School of Medicine, President of the International Menopause Society and co-author of the ‘Update on bone health’ report said:

“Bone health is a crucial issue for midlife women.

“It’s fantastic that life expectancy continues to grow across the world but it does mean that the amount of people suffering from osteoporosis and/or sarcopenia is also increasing. This can significantly affect their day to day functioning, quality of life and ability to live independently. 

“Worldwide, osteoporosis causes more than 8.9 million fractures annually. The implications of this are extremely serious, sadly 21% of women who fracture their hip will die within one year.

“In addition, poor bone health places a huge burden on health and social care systems globally.”

Tobie de Villiers, consultant gynecologist associated with Stellenbosch University, Cape Town, South Africa and co-author of the ‘Update on bone health’ report added:

Osteoporosis is often referred to as a “silent disease”. Previously, it was only diagnosed when a fracture occurred, but we can now make predictions using the presence of risk factors and women should be helped by health services to make lifestyle changes or discuss the need for specific medication to restore bone strength.

“Health care practitioners should also acknowledge the increased fracture risk associated with osteosarcopenia so that diagnosis and treatment becomes part of routine health care for post-menopausal women.” 

The IMS advises women to maintain healthy bones by increasing their dietary intake of calcium, vitamin D and protein, using exercise (especially weight-bearing, balance exercises and strength training) to maintain muscle mass, avoiding smoking and limiting alcohol.  Avoiding fractures is also very important as both women and men get older. For some women, hormone replacement therapy in menopause can also be very effective in maintaining bone health. 

The report is available on the IMS website alongside advice for women who may be suffering from poor bone health. 

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