Ladies, beware of fractures post-menopause

Just hit your menopause? You must read this!

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October 20 is World Osteoporosis Day.

The number of osteoporosis cases is rising and one of the most common reason for this rise is the lack of calcium and vitamin D in one's diet. Osteoporosis mostly affects women and post-menopausal women are more at risk. It is characterised by weak bones and it increases the chances of recurrent fractures, joint pain, back pain and a stooped posture are also a few symptoms of the disease. The treatment of osteoporosis includes hormone replacement therapy and surgery, hence preventing the disease is the best solution. Dr Syamasis Bandyopadhyay, MD Rheumatology at Apollo Gleneagles, explains how women can prevent fractures and what they should do to heal quickly after a fracture.

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How can a women prevent having fractures?

Although osteoporois is common in women, it affects men too. In both ,the key to avoid any complications is to prevent fractures. The tips mentioned here are for post-menopausal women. There are two types of preventions primary prevention and secondary prevention.

Primary prevention

The first thing post-menopausal women should aim for is to prevent a fall-the cause for most fractures. Fractures are critical in post menopausal women because even trivial injuries can lead to fractures which is not the case in young people. As bones are fragile, such trivial fractures are called fragility fractures.Women are most likely to suffer to fracture their hips, pelvis, wrist or the spine. In the case of the spinal column, a woman may see a gradual bending or stooping in her posture. This is most likely due to the formation of a spontaneous wedge fracture in the vertebrae. This happens spontaneously and one might not even notice that something is wrong. In some cases, this may fracture and cause nervous deficits.

So, unless and until it is contraindicated, post-menopausal women should take calcium. Ideally a woman should start from the peri-menopausal period (the menopause transition years). Calcium supplements should be avoided if the woman suffers from kidney stones or has excess calcium in the blood.

Also, apart from calcium, women in India, one should always take vitamin D supplements. It is important because vitamin D is what helps the body absorb calcium properly. Without vitamin D all the supplemental calcium will not be utilised by the body and thrown out. So it s important to increase take both calcium and vitamin D, eating either won t help.

Secondary prevention

In post-menopausal women with fragility fracture, they are prescribed medicines that reduce the chances of another fractures. They are usually prescribed calcium supplements, vitamin D3 supplements, bisphosphonate, strongium, parathormone, calcitonin and some women also undergo HRT (Hormone Replacement Therapy). This is a type of therapy that involves replacing the lost oestrogen in the woman's body. Since the sudden depletion of this hormone is what is known to expedite the onset of osteoporosis, this therapy is highly beneficial, but is used only in a few serious cases. A woman can take bisphosphonate monthly or weekly.

What care can a woman take while recuperating from a fracture?

Usually it takes about six weeks to heal a fracture in the upper arm and about three months in the lower leg. In the case of osteoporotic women, this healing process takes longer and they require more care than a normal fracture. Although in most cases of fragility fractures, a surgeon will use various techniques to help the fracture heal, there are few things that can be done to hasten the process. Some of the most common methods are to eat a healthy diet, eat calcium and vitamin D supplements and take proper care of the injured area. It is important to remember that one should not have bisphosphonate while the fracture is healing, as it hampers the fusion of the broken parts. If a woman has very brittle bones, then the doctor might prescribe parathormone (a drug that uses hormone replacement to help the assimilation of calcium better) to help the bones heal better.

Has the disease trend changed?

Actually fracture rates have gone down overall because of a more conscious society. Now people have become more aware and there are more advanced treatment options. But, having said that, there is no place for complacency, because, we have a lot more to achieve when it comes to fighting this disease.