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Early menopause gives rise to many health conditions in women and osteoporosis is one of them. This happens because menopause causes loss of bone density. But women who experience early menopause have more chances of weak and brittle bones as compared to others who have a late menopause. The risk of osteoporosis in their late 70s goes up by more than 50 per cent if menopause comes before the age of 47 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.
During the menopausal transition period or perimenopause, the average reduction in bone mineral density (BMD) is about 10 per cent. 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, according to Dr Meenakshi Banerjee, Senior Consultant, Obstetrics and Gynaecology, Madhukar Rainbow Children's Hospital, Delhi.
Dr Neha Khandelwal, Senior Consultant - Obstetrics and Gynaecology, Madhukar Rainbow Children's Hospital, Delhi, also says that various reasons of early menopause can be genetic. 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 during perimenopause, there is an increased bone loss due to decreasing estrogen levels. This makes women more prone for osteoporosis. To reduce the loss of bone and other postmenopausal symptoms like vaginal dryness and hot flushes, hormone replacement therapy in the form of estrogen is beneficial. But their use should be done with utmost caution after screening women whether she will be best benefited with this therapy.
According to Dr Khanadelwal, "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 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 antiestrogen medications and steroid medications for more than three months.
Low level of physical activity, smoking and alcohol intake and high body weight increases susceptibility to osteoporosis. Positive lifestyle modifications can help tremendously. Dr Banerjee says that walking and gentle aerobics are excellent for bone health. It promotes 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. Fresh fruit and vegetables offer a 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 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. People who experience early menopause should expose their body to sunlight for 20 minutes e very everyday. You can also get this nutrient from foods like milk and dairy products, fish liver oils, sardines, herring, salmon and tuna.
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